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General NPI Number Information
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NPI Number | 1437016516
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Entity Type | Individual
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Provider Name | MERCEDES JEFFERSON LLMFT
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Gender | Female
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 628 E PARENT AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-3765
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Country | US
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Telephone | 248-221-2734
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Fax |
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Provider Business Mailing Address
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Address Line | 30544 CANTABARRY APT 22-202
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City | ROSEVILLE
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State | MI
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Zip | 48066-7746
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Country | US
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Telephone | 586-337-1365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4151001209
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License Number State | MI
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