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General NPI Number Information
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NPI Number | 1750431763
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Entity Type | Organization
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Legal Business Name | MERCED COUNSELING, INC.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1342 COLONIAL BLVD BUILDING F SUITE 41A
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City | FORT MYERS
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State | FL
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Zip | 33907-1013
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Country | US
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Telephone | 239-277-3117
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Fax | 239-936-2696
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Provider Business Mailing Address
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Address Line | 1342 COLONIAL BLVD BUILDING F SUITE 41A
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City | FORT MYERS
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State | FL
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Zip | 33907-1013
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Country | US
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Telephone | 239-277-3117
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Fax | 239-936-2696
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | CYNTHIA MERCED
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Credential | LCSW
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Telephone | 239-277-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW8129
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License Number State | FL
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