Provider Demographics
NPI:1356788913
Name:MITCHELL, JESSE REECE (BCPPC, DIV, PHD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:REECE
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:BCPPC, DIV, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:AL
Mailing Address - Zip Code:35570-3015
Mailing Address - Country:US
Mailing Address - Phone:205-792-1443
Mailing Address - Fax:
Practice Address - Street 1:149 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:AL
Practice Address - Zip Code:35570-3015
Practice Address - Country:US
Practice Address - Phone:205-792-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral