| Merclan Pllc | |
|
6200 Crestwood Sta Suite A Crestwood KY 40014-7418 | |
| (502) 241-2909 | |
| (502) 241-6811 |
| Full Name | Merclan Pllc |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 6200 Crestwood Sta, Crestwood, Kentucky |
| Authorized Official Name and Position | Jeffery T Mercer (OWNER/PRESIDENT) |
| Authorized Official Contact | 5022412909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Merclan Pllc Po Box 73070 Cleveland OH 44193-0002 Ph: (502) 241-2909 | Merclan Pllc 6200 Crestwood Sta Suite A Crestwood KY 40014-7418 Ph: (502) 241-2909 |
| NPI Number | 1487687174 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 07/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487687174 | NPI | - | NPPES |
| 659444007 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Secondary |
| 103TP2701X | Psychologist - Group Psychotherapy | (Kentucky) | Primary |
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