Provider Demographics
NPI:1740974286
Name:FLOYD, MERCEDES (LMSW)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:FLOYD
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:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-0084
Mailing Address - Country:US
Mailing Address - Phone:731-215-3257
Mailing Address - Fax:
Practice Address - Street 1:1312 DOWSLEY DR
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-1592
Practice Address - Country:US
Practice Address - Phone:731-215-3257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14130104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker