| Josie D Mitchell | |
|
105 W Prairie Ave Ogden IL 61859-8808 | |
| (217) 274-2363 | |
| Not Available |
| Full Name | Josie D Mitchell |
|---|---|
| Speciality | Social Worker |
| Location | 105 W Prairie Ave, Ogden, Illinois |
| Authorized Official Name and Position | Josie Dorthea Mitchell (LCSW/OWNER) |
| Authorized Official Contact | 7657613997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Josie D Mitchell Po Box 374 Ogden IL 61859-0374 Ph: (217) 274-2363 | Josie D Mitchell 105 W Prairie Ave Ogden IL 61859-8808 Ph: (217) 274-2363 |
| NPI Number | 1255052866 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 04/15/2023 |
| Certification Date | 04/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255052866 | NPI | - | NPPES |
| 1740650530 | Medicaid | IL | |
| 149019804 | Other | IL | LCSW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
Ruby Waves Of Wellness, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 W Prairie Ave, Ogden, IL 61859 Phone: 765-761-3997 Fax: 217-670-6712 |