Healthcare Provider Details

I. General information

NPI: 1366509085
Provider Name (Legal Business Name): MERCURY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

896 E MAIN ST SUITE 6
GREENWOOD IN
46143-1440
US

IV. Provider business mailing address

896 E MAIN ST SUITE 6
GREENWOOD IN
46143-1440
US

V. Phone/Fax

Practice location:
  • Phone: 317-881-5050
  • Fax:
Mailing address:
  • Phone: 317-881-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number20040086
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34000809A
License Number StateIN

VIII. Authorized Official

Name: DAVID A. WILKERSON
Title or Position: PRESIDENT
Credential: MSW, LCSW
Phone: 317-881-5050