Provider Demographics
NPI:1831920388
Name:NEW MERCIES COUNSELING LLC
Entity type:Organization
Organization Name:NEW MERCIES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:ZACK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:218-591-8590
Mailing Address - Street 1:4474 W CALVARY RD
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55803-1269
Mailing Address - Country:US
Mailing Address - Phone:218-591-8590
Mailing Address - Fax:
Practice Address - Street 1:4474 W CALVARY RD
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:MN
Practice Address - Zip Code:55803-1269
Practice Address - Country:US
Practice Address - Phone:218-591-8590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty