Individual provider · Type 1 NPI

Jaclyn Mixell

Professional Counselor · St. Louis, MO

NPI number 1114891025 Active

Practice location

1612 S Big Bend Blvd
St. Louis, MO 63117-2208

Other practice locations

  • 409 S Florissant Rd Ste 101, Ferguson, MO 63135-2894 · (314) 529-1391

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X2025025003 (MO)

Professional Counselor: Definition to come...

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About NPI 1114891025

Jaclyn Mixell's National Provider Identifier is 1114891025, issued on Oct 2, 2025. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis, MO. The record was last updated on Oct 2, 2025.