Individual
MR. ALPHONSO MITCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
113 HOLLAND AVE, ALBANY, NY 12208-3410
(518) 626-5162
(518) 462-3099
Mailing address
350 CLINTON AVENUE, ALBANY, NY 12206
(518) 626-5317
(518) 626-5407
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
069423-1
NY
Other
Enumeration date
10/02/2006
Last updated
07/28/2008
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