Mr Travis A Mitchell Sr, PHYSICOLOGIST is a
Psychologist - Addiction (substance Use Disorder) based in Saint Louis, Missouri. Mr Travis A Mitchell Sr is licensed to practice in Missouri (license number 5653) and his current practice location is
8759 Annetta Ave, Saint Louis, Missouri. He can be reached at his office (for appointments etc.) via phone at
(314) 381-4225.
NPI number for Mr Travis A Mitchell Sr is 1750655890 and his current mailing address is 8759 Annetta Ave, Saint Louis, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1750655890.
Healthcare Provider's Profile
| Full Name | Mr Travis A Mitchell Sr |
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| Gender | Male |
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| Speciality | Psychologist - Addiction (substance Use Disorder) |
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| Location | 8759 Annetta Ave, Saint Louis, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1750655890
- Provider Enumeration Date: 03/07/2012
- Last Update Date: 03/07/2012
Medical Identifiers
Medical identifiers for Mr Travis A Mitchell Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750655890 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 4718 (Missouri) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 103 (Missouri) | Secondary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | 5653 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Travis A Mitchell Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Travis A Mitchell Sr, PHYSICOLOGIST
8759 Annetta Ave,
Saint Louis, MO 63147-1602
Ph: (314) 381-4225 | Mr Travis A Mitchell Sr, PHYSICOLOGIST
8759 Annetta Ave,
Saint Louis, MO 63147-1602
Ph: (314) 381-4225 |
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