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NPI Code Detail

MEDICARE: JASON MERCER

MEDICARE: JASON MERCER
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
1101YA0400XAddiction (Substance Use Disorder) Counselor1511LA
2101YP2500XProfessional Counselor8962LA

General Provider Information

NPI Number : 1457724734
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON MERCER
Provider Business Mailing Address
First Line : 703 RIDGEWOOD BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3331
Country : US
Telephone Number : 318-542-8388
Fax Number :
Provider Business Practice Location Address
First Line : 703 RIDGEWOOD BLVD
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71303-3331
Country : US
Telephone Number : 318-542-8388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2015
Last Update Date : 05/05/2024

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Directions to “ JASON MERCER ” Practice Location

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