Douglas Eugene Mitchem
Individual provider Active NPI Clinical Social Worker · Rock Falls, IL
NPI 1609012707 · NPPES record last updated Dec 20, 2008
Key facts
- NPI
- 1609012707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 1600 Riverdale Rd Lot 42
Rock Falls, IL 61071-2450 - Phone
- (815) 441-4195
- NPI assigned
- Dec 20, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
1600 Riverdale Rd Lot 42
Rock Falls, IL 61071-2450
Mailing address
1600 Riverdale Rd Lot 42
Rock Falls, IL 61071-2450
Phone (815) 441-4195
Other providers in Rock Falls, IL
- Sarah Mathew
- Midwest Health Operations LLC
- Cali J Miles
- Whitney Lynn Miller
- Mindfulness Institute of NW Illinois
- Payton Moe
- Montmorency C C S D 145
- Tammy Jo Moran
- Jeanne Heather Nailor
- New Hope Chiropractic, LTD
All providers in Rock Falls, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.