Provider Demographics
NPI:1487234423
Name:CONNORS, MERCY JEREMANE (PHD)
Entity type:Individual
Prefix:DR
First Name:MERCY
Middle Name:JEREMANE
Last Name:CONNORS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MERCY
Other - Middle Name:JEREMANE
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1117 WHISPERING OAKS LN
Mailing Address - Street 2:
Mailing Address - City:GOODE
Mailing Address - State:VA
Mailing Address - Zip Code:24556-3020
Mailing Address - Country:US
Mailing Address - Phone:434-907-0234
Mailing Address - Fax:
Practice Address - Street 1:20564 TIMBERLAKE RD STE B
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7246
Practice Address - Country:US
Practice Address - Phone:434-384-1594
Practice Address - Fax:434-384-3228
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008672101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional