Most Relevant Information
Provider Data
| NPI Number: | 1003313461 |
| Provider Name: | JOHNNY LEE MITCHELL LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | CSW006787 |
Most Important Dates
| Enumeration Date: | 04/11/2018 |
| Last Updated: | 04/08/2020 |
Provider Practice Location
175 GWINNETT DR
LAWRENCEVILLE
GA
300468444
Practice Location Phone/Fax
| Phone: | 6782092411 |
| Fax: |
Provider Mailing Location
2672 THOMPSON MILL RD
BUFORD
GA
305195461
Provider Mailing Phone/Fax
| Phone: | 8145216607 |
| Fax: |