MEDICARE: DARLA MERSMAN MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	68428	TX

General Provider Information

NPI Number	:	1497027759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARLA MERSMAN MA, LPC

Provider Business Mailing Address
First Line	:	PO BOX 920453
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-0009
Country	:	US
Telephone Number	:	970-270-5759
Fax Number	:

Provider Business Practice Location Address
First Line	:	945 S MESA HILLS DR
Second Line	:	#3811
City	:	EL PASO
State	:	TX
Zip	:	79912-5122
Country	:	US
Telephone Number	:	970-270-5759
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DARLA MERSMAN
Credential	:	MA, LPC
Telephone Number	:	970-270-5759

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	02/02/2012

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