Provider Demographics
NPI:1427326834
Name:MERCKERSON, CLARENCE DEQUAN (LPC)
Entity type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:DEQUAN
Last Name:MERCKERSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 US HIGHWAY 231 STE F
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36093-1224
Mailing Address - Country:US
Mailing Address - Phone:334-322-7212
Mailing Address - Fax:334-567-6341
Practice Address - Street 1:4035 US HIGHWAY 231 STE F
Practice Address - Street 2:
Practice Address - City:WETUMPKA
Practice Address - State:AL
Practice Address - Zip Code:36093-1224
Practice Address - Country:US
Practice Address - Phone:334-322-7212
Practice Address - Fax:334-478-4983
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional