Individual
LARRY MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA CAADC SPADA
Contact information
Practice address
1960 MILLBROOK ST SE, GRAND RAPIDS, MI 49508-2636
(616) 633-3700
(616) 930-4640
Mailing address
1960 MILLBROOK ST SE, GRAND RAPIDS, MI 49508-2636
(616) 633-3700
(616) 930-4640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C-00112
MI
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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