Provider Demographics
NPI:1023546959
Name:MERCHANT, MISSY SYLAR (LPC, CAADC)
Entity Type:Individual
Prefix:MRS
First Name:MISSY
Middle Name:SYLAR
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:MRS
Other - First Name:MISSY
Other - Middle Name:SUE
Other - Last Name:MERCHANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CAADC
Mailing Address - Street 1:6987 WALKER ROAD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:MI
Mailing Address - Zip Code:49705-9787
Mailing Address - Country:US
Mailing Address - Phone:231-330-2670
Mailing Address - Fax:
Practice Address - Street 1:1260 AJIJAAK AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8330
Practice Address - Country:US
Practice Address - Phone:231-242-1640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017488101YP2500X
MI6401015284101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional