Individual
MANDY KIMBALL MERCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
175 EMERY HWY, MACON, GA 31217-3692
(478) 803-7625
(478) 751-4530
Mailing address
175 EMERY HWY, MACON, GA 31217-3692
(478) 803-7631
(478) 751-4530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW003931
GA
1041C0700X
Clinical Social Worker
Primary
CSW004051
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW004051
LCSW
GA
Enumeration date
02/08/2007
Last updated
05/18/2012
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