Provider Demographics
NPI:1477430486
Name:MITCHELL, TASEAN
Entity type:Individual
Prefix:
First Name:TASEAN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 WESTCHESTER DR APT 116
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2567
Mailing Address - Country:US
Mailing Address - Phone:330-219-5968
Mailing Address - Fax:330-219-5968
Practice Address - Street 1:4851 WESTCHESTER DR APT 116
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2567
Practice Address - Country:US
Practice Address - Phone:330-219-5968
Practice Address - Fax:330-219-5968
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child