Mr Carl L Mitchell Jr, LSCSW | |
220 E. Chestnut, Independence, KS 67301 | |
(620) 331-0057 | |
Not Available |
Full Name | Mr Carl L Mitchell Jr |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 220 E. Chestnut, Independence, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134157167 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 3844 (Kansas) | Primary |
Entity Name | Four County Mental Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841290251 PECOS PAC ID: 7012904071 Enrollment ID: O20040430000887 |
Mailing Address | Practice Location Address |
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Mr Carl L Mitchell Jr, LSCSW 3751 W. Main, Independence, KS 67301 Ph: (620) 331-0057 | Mr Carl L Mitchell Jr, LSCSW 220 E. Chestnut, Independence, KS 67301 Ph: (620) 331-0057 |
Janet West, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1101 Donald Ave, Independence, KS 67301 Phone: 620-331-1748 | |
Cassie Nicolette Houf, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3925 Cr 3800, Independence, KS 67301 Phone: 636-359-4385 | |
Terry Goodspeed, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Miss Dacia Christine Thiele, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 200 Arco Suite 501, Independence, KS 67301 Phone: 620-332-1230 | |
Yehoshua M. Othniel, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3751 W Main St, Independence, KS 67301 Phone: 620-331-1748 | |
Ms. Marie Elaine Ingram, LSCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1101 Donald Ave, Independence, KS 67301 Phone: 620-331-3481 Fax: 620-332-5130 |