Provider Demographics
NPI:1356678932
Name:MERCER, BARBARA SUE (CDCII)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:SUE
Last Name:MERCER
Suffix:
Gender:F
Credentials:CDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9951 STEPHEN RICHARDS DR
Mailing Address - Street 2:#89-A
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9666
Mailing Address - Country:US
Mailing Address - Phone:907-364-4410
Mailing Address - Fax:907-364-4484
Practice Address - Street 1:3245 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7809
Practice Address - Country:US
Practice Address - Phone:907-364-4414
Practice Address - Fax:907-364-4484
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3012101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)