Mitchem, Teresa Danielle

Mitchem, Teresa Danielle is an sole proprietor health care provider with primary practice located at 414 Lake Howell Rd , Maitland FL 32751-5900. She recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Social Worker, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Agencies / Case Management. Agencies / Case Management is her primary health care specialty. Mitchem, Teresa Danielle can be contacted via phone (407) 637-2633.

Contact Information

Primary practice address
414 Lake Howell Rd Maitland FL 32751-5900
Phone: (407) 637-2633
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / School 101YS0200X
Behavioral Health & Social Service Providers / Social Worker 104100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Agencies / Case Management 251B00000X
Agencies / Case Management 251B00000X 100523 Florida

Profile Details

NPI number 1225385602
LBN Legal business name Mitchem, Teresa Danielle
Credentials MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2012
Last updated Sep 9th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225385602 NPPES
Florida MEDICAID 105479600
Florida MEDICAID 013510800

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