| Doctor Name: | MR. DAVID RICHARD MITCHELL |
| NPI Number: | 1609882646 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LCSW |
| License Number: | 149-001264 |
| Business Practice Address: | 25283 W Timber Ln Lake Villa, IL - 600467372 |
| Business Phone Number: | 8475872222 |
| Business Fax Number: | 8475877656 |
| Mailing Address: | 25283 W Timber Ln, LAKE VILLA |
| State: | IL |
| Postal Code: | 600467372 |
| Phone Number: | 8475872222 |
| Fax Number: | 8475877656 |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149-001264 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |