Provider Demographics
NPI:1366172108
Name:MITCHELL, SHARON LUREE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LUREE
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 N MARKET ST APT 2
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32206-3782
Mailing Address - Country:US
Mailing Address - Phone:904-238-1715
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S HOME SOCIETY
Practice Address - Street 2:3027 SAN DIEGO ROAD
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-381-6352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health