Mercer, Mandy Kimball

Mercer, Mandy Kimball is an individual health care provider with primary practice located at 175 Emery Hwy , Macon GA 31217-3692. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Mercer, Mandy Kimball can be contacted via phone (478) 803-7625.

Contact Information

Primary practice address
175 Emery Hwy Macon GA 31217-3692
Fax: (478) 751-4530
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X MSW003931 Georgia
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW004051 Georgia

Profile Details

NPI number 1295876928
LBN Legal business name Mercer, Mandy Kimball
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated May 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295876928 NPPES
Georgia Other CSW004051 LCSW

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