Healthcare Provider Details

I. General information

NPI: 1275958902
Provider Name (Legal Business Name): JENNIFER MERCER MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24715 LITTLE MACK AVE STE 200
SAINT CLAIR SHORES MI
48080-3207
US

IV. Provider business mailing address

22592 VAN ST
SAINT CLAIR SHORES MI
48081-2499
US

V. Phone/Fax

Practice location:
  • Phone: 517-882-3732
  • Fax: 517-882-3633
Mailing address:
  • Phone: 586-915-2546
  • Fax: 313-321-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401012523
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: