| Doctor Name: | KEVIN MERTENS |
| NPI Number: | 1255409710 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | 002722 |
| Business Practice Address: | 17 Flaherty Rd Storrs, CT - 062682301 |
| Business Phone Number: | 8606170510 |
| Business Fax Number: | |
| Mailing Address: | 1401 Autumn Chase, ELLINGTON |
| State: | CT |
| Postal Code: | 060293747 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 04/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 002722 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |