Healthcare Provider Details

I. General information

NPI: 1043020688
Provider Name (Legal Business Name): JENNIFER MERCER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17852 MAUMEE AVE
GROSSE POINTE MI
48230-1612
US

IV. Provider business mailing address

32680 S RIVER RD
HARRISON TOWNSHIP MI
48045-5704
US

V. Phone/Fax

Practice location:
  • Phone: 313-246-4331
  • Fax:
Mailing address:
  • Phone: 586-915-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LYNN MERCER
Title or Position: CEO
Credential: LPC
Phone: 586-915-2546