Provider Demographics
NPI:1679061626
Name:LAWRENCE MARSH, MERCEDES (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:
Last Name:LAWRENCE MARSH
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:MERCEDES
Other - Middle Name:S
Other - Last Name:LAWRENCE MARSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:2059 SCENIC HWY N STE 101
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6141
Practice Address - Country:US
Practice Address - Phone:470-327-9193
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-24-71217103K00000X
GA12471217103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst