Provider Demographics
NPI:1083420665
Name:MERCY RIVER COUNSELING
Entity type:Organization
Organization Name:MERCY RIVER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-986-3045
Mailing Address - Street 1:111 N JEFFERSON ST STE 7
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1553
Mailing Address - Country:US
Mailing Address - Phone:269-986-3045
Mailing Address - Fax:
Practice Address - Street 1:111 N JEFFERSON ST STE 7
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1553
Practice Address - Country:US
Practice Address - Phone:269-986-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty