Provider Demographics
NPI:1528391224
Name:SOUDER, MERCY (EDS)
Entity Type:Individual
Prefix:MRS
First Name:MERCY
Middle Name:
Last Name:SOUDER
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:HENNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-4004
Mailing Address - Country:US
Mailing Address - Phone:540-434-2800
Mailing Address - Fax:540-434-2883
Practice Address - Street 1:110 NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4004
Practice Address - Country:US
Practice Address - Phone:540-434-2800
Practice Address - Fax:540-434-2883
Is Sole Proprietor?:No
Enumeration Date:2009-09-12
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional