Provider Demographics
NPI:1235977166
Name:MITCHELL, MARY HOPE (LCPC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:HOPE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N WABASH AVE UNIT 3205
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5675
Mailing Address - Country:US
Mailing Address - Phone:847-324-3507
Mailing Address - Fax:
Practice Address - Street 1:405 N WABASH AVE UNIT 3205
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5675
Practice Address - Country:US
Practice Address - Phone:847-324-3507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health