Provider Demographics
NPI:1578570164
Name:MERCURIO, LYNN BARBARA (LCPC)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:BARBARA
Last Name:MERCURIO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WEXFORD DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-0913
Mailing Address - Country:US
Mailing Address - Phone:217-224-8344
Mailing Address - Fax:
Practice Address - Street 1:529 HAMPSHIRE ST STE 308
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2935
Practice Address - Country:US
Practice Address - Phone:217-222-3991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional