Provider Demographics
NPI:1578923322
Name:MERGO, RACHEL NICOLE (MA, LLPC, LLMFT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:NICOLE
Last Name:MERGO
Suffix:
Gender:F
Credentials:MA, LLPC, LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BROOKVIEW CT
Mailing Address - Street 2:APT 301
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4501
Mailing Address - Country:US
Mailing Address - Phone:740-701-2186
Mailing Address - Fax:
Practice Address - Street 1:1025 E MAPLE RD
Practice Address - Street 2:SUITE B-7A
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6426
Practice Address - Country:US
Practice Address - Phone:740-701-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015151101YP2500X
MI4101006663106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist