Individual
LAJUANA EBONY MARY MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4802 E RAY RD STE 23-266, PHOENIX, AZ 85044-6405
(602) 620-5507
(602) 491-2677
Mailing address
4802 E RAY RD SUITE 23-266, PHOENIX, AZ 85044-0620
(602) 620-5507
(602) 491-2677
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401013734
MI
101YM0800X
Mental Health Counselor
LPC16755
AZ
101YP2500X
Professional Counselor
6401013734
MI
101YP2500X
Professional Counselor
Primary
LPC-16755
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277387
—
AZ
Enumeration date
04/29/2017
Last updated
02/04/2025
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