Provider Demographics
NPI:1437241445
Name:MERCER, DELINDA (PHD, MSCP)
Entity Type:Individual
Prefix:
First Name:DELINDA
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:PHD, MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 BAXTER BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-1827
Mailing Address - Country:US
Mailing Address - Phone:207-774-8700
Mailing Address - Fax:207-253-1523
Practice Address - Street 1:53 BAXTER BLVD STE 3
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-1827
Practice Address - Country:US
Practice Address - Phone:207-774-8700
Practice Address - Fax:207-253-1523
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE586103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00038919OtherRR MEDICARE
276717Medicare PIN
P00038919OtherRR MEDICARE