Individual provider Active NPI

Carrie Marie Mercer, MSW, LCSW

  • Clinical Social Worker
  • Potosi, MO
National Provider Identifier
1619237278
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2012014020 Issued in MO
Practice address
1 Kwan PLZ
Potosi, MO 63664-1435
Phone
(573) 438-5451
Fax
(573) 438-0007
NPI assigned
May 16, 2012
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2012014020 MO Primary

Addresses

Primary practice location

1 Kwan PLZ
Potosi, MO 63664-1435

Mailing address

1 Kwan Plaza
Potosi, MO 63664-1899
Phone (573) 438-0751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140423001964 MO Order and Referring Only - Clinical Social Worker 7416180633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Choose Change Convince Counseling Current Accepting new patients

Locations

10071 Crescent Rd
Potosi, MO 63664
Phone (573) 438-2200

Interoperability endpoints

  • Direct secure messaging: carrie.mercer.p1@direct.wcmh-clinics.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1619237278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KWAN PLAZA",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641899",
            "telephone_number": "573-438-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KWAN PLZ",
            "city": "POTOSI",
            "state": "MO",
            "postal_code": "636641435",
            "telephone_number": "573-438-5451",
            "fax_number": "573-438-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "CARRIE",
        "middle_name": "MARIE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-16",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2012014020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potosi, MO

Sources for this page

Verify at the official NPI Registry.