Provider Demographics
NPI:1972658177
Name:TRZECIAK-KERR, M. M (LMHC)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:M
Last Name:TRZECIAK-KERR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:M.
Other - Middle Name:M
Other - Last Name:TRZECIAK-KERR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:2688 FRUITVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5223
Mailing Address - Country:US
Mailing Address - Phone:941-366-2224
Mailing Address - Fax:
Practice Address - Street 1:2688 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237
Practice Address - Country:US
Practice Address - Phone:941-366-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0217404000Medicaid