Provider Demographics
NPI:1013035328
Name:MERCURIO, MARIA ELENA (LCSW,BCD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:MERCURIO
Suffix:
Gender:F
Credentials:LCSW,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 W 62ND ST
Mailing Address - Street 2:SUITE 9-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7000
Mailing Address - Country:US
Mailing Address - Phone:212-582-9553
Mailing Address - Fax:
Practice Address - Street 1:62 W 62ND ST
Practice Address - Street 2:SUITE 9C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7000
Practice Address - Country:US
Practice Address - Phone:212-582-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR023144-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical