Provider Demographics
NPI:1366013377
Name:MERCIER-KENNEDY, SARA M (MS CMHC, RMHC-I, NCC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:MERCIER-KENNEDY
Suffix:
Gender:F
Credentials:MS CMHC, RMHC-I, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 LAKETREE LN APT B
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1626
Mailing Address - Country:US
Mailing Address - Phone:970-980-8251
Mailing Address - Fax:
Practice Address - Street 1:6011 LAKETREE LN APT B
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-1626
Practice Address - Country:US
Practice Address - Phone:970-980-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH21144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health