Individual
TIA MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
203 W 140TH ST APT 1A, NEW YORK, NY 10030-3499
(917) 650-2158
Mailing address
203 W 140TH ST APT 1A, NEW YORK, NY 10030-3499
(917) 650-2158
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
131043
NY
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/27/2020
Last updated
03/19/2026
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