Basic Information
| Provider Information | |||||||||
| NPI: | 1578731485 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MITCHELL | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 966 JEFFERSON ST APT 2 | ||||||||
| Address2: | |||||||||
| City: | DELANO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932152259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617219510 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2737 WEST CECIL AVE. | ||||||||
| Address2: | |||||||||
| City: | DELANO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932150567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6617212345 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2008 | ||||||||
| LastUpdateDate: | 02/13/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS 13409 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.