Healthcare Provider Details

I. General information

NPI: 1306722715
Provider Name (Legal Business Name): MERCEDES UNGER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERCEDES MARSON

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 W BUSINESS 380 STE 100
DECATUR TX
76234-3267
US

IV. Provider business mailing address

195 RUNNING RIVER DR
BOYD TX
76023-4040
US

V. Phone/Fax

Practice location:
  • Phone: 940-539-0683
  • Fax:
Mailing address:
  • Phone: 805-952-5407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116582
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: