Provider Demographics
NPI:1508741869
Name:MITCHELL, ADAM (CPC-INTERN)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:CPC-INTERN
Other - Prefix:MR
Other - First Name:ADAM
Other - Middle Name:
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPC-INTERN
Mailing Address - Street 1:4400 S JONES BLVD UNIT 3095
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3358
Mailing Address - Country:US
Mailing Address - Phone:661-486-2638
Mailing Address - Fax:
Practice Address - Street 1:3127 E WARM SPRINGS RD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3134
Practice Address - Country:US
Practice Address - Phone:702-850-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI5601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health