Provider Demographics
NPI:1699075416
Name:MERCURE, RODNEY HENRY (LMHC)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:HENRY
Last Name:MERCURE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:HENRY
Other - Middle Name:RODNEY
Other - Last Name:MERCURE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:4613 CAMDEN CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3562
Mailing Address - Country:US
Mailing Address - Phone:505-877-4873
Mailing Address - Fax:
Practice Address - Street 1:4613 CAMDEN CT NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3562
Practice Address - Country:US
Practice Address - Phone:505-877-4873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0101711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health