Provider Demographics
NPI:1053147629
Name:MITCHELL, SHELBY ELIZABETH (LMSW, C-SWI)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:ELIZABETH
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LMSW, C-SWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 CONTINENTAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-6921
Mailing Address - Country:US
Mailing Address - Phone:702-325-3620
Mailing Address - Fax:
Practice Address - Street 1:801 S RANCHO DR STE E3A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3812
Practice Address - Country:US
Practice Address - Phone:702-620-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11748-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker