Provider Demographics
NPI:1730523085
Name:MITCHELL, MERIKAY (CMHC)
Entity type:Individual
Prefix:
First Name:MERIKAY
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 WEST JAYDA LYN CT
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1720
Mailing Address - Country:US
Mailing Address - Phone:801-557-4828
Mailing Address - Fax:
Practice Address - Street 1:2225 E. MURRAY HOLLADAY RD
Practice Address - Street 2:#108
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-1720
Practice Address - Country:US
Practice Address - Phone:385-313-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT288375-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health