MEDICARE: MERC ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY0741	NV

General Provider Information

NPI Number	:	1124410170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERC ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	5420 W SAHARA AVE
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0394
Country	:	US
Telephone Number	:	702-800-7258
Fax Number	:

Provider Business Practice Location Address
First Line	:	5840 W CRAIG RD
Second Line	:	SUITE 120-169
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2561
Country	:	US
Telephone Number	:	702-800-7258
Fax Number	:	702-645-6218

Authorized Official
Title or Position	:	MEMBER
Name	:	MARY LISA LAMB
Credential	:	PHD
Telephone Number	:	702-800-7258

Provider Enumeration Date	:	02/28/2015
Last Update Date	:	02/28/2015

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Directions to “MERC ASSOCIATES LLC ” Practice Location

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