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General NPI Number Information
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NPI Number | 1306546353
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Entity Type | Organization
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Legal Business Name | MERCURY MENTAL HEALTH LLC
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 205 N COLLEGE AVE STE 216
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City | BLOOMINGTON
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State | IN
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Zip | 47404-3955
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Country | US
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Telephone | 720-254-1353
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Fax | 949-695-2240
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Provider Business Mailing Address
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Address Line | 358 S EAST ST
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City | SPENCER
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State | IN
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Zip | 47460-1814
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Country | US
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Telephone | 812-821-7130
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Fax | 970-540-5636
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL PARMENTER
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Credential | PMHNP
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Telephone | 812-821-7130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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