Provider Demographics
NPI:1477989085
Name:MERCIER, TONYA LYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:LYNN
Last Name:MERCIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31469 YORK ST
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-3647
Mailing Address - Country:US
Mailing Address - Phone:313-725-1847
Mailing Address - Fax:313-347-4369
Practice Address - Street 1:31469 YORK ST
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-3647
Practice Address - Country:US
Practice Address - Phone:313-725-1847
Practice Address - Fax:313-347-4369
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010953321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1477989085Medicaid