| Tara Mitchell, Lcsw | |
|
904 N Main St Ste C Cleburne TX 76033-3803 | |
| (817) 645-3328 | |
| Not Available |
| Full Name | Tara Mitchell, Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 904 N Main St Ste C, Cleburne, Texas |
| Authorized Official Name and Position | Tara Mitchell (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8176453328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Mitchell, Lcsw 2250 Hopewell Rd Cleburne TX 76031-0384 Ph: (757) 581-3646 | Tara Mitchell, Lcsw 904 N Main St Ste C Cleburne TX 76033-3803 Ph: (817) 645-3328 |
| NPI Number | 1245830991 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 06/23/2022 |
| Certification Date | 06/23/2022 |
| Medicare PECOS PAC ID | 2365853132 |
|---|---|
| Medicare Enrollment ID | O20201130001664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245830991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tara Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851991723 PECOS PAC ID: 3274944046 Enrollment ID: I20201130001727 |
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