Provider Demographics
NPI:1194022475
Name:MERCER, WENDY MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE
Last Name:MERCER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BUCKNELL RD
Mailing Address - Street 2:
Mailing Address - City:WEST SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11796-1004
Mailing Address - Country:US
Mailing Address - Phone:631-872-5451
Mailing Address - Fax:
Practice Address - Street 1:105 BUCKNELL RD
Practice Address - Street 2:
Practice Address - City:WEST SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11796-1004
Practice Address - Country:US
Practice Address - Phone:631-872-5451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004687-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health