Provider Demographics
NPI:1376984914
Name:MERCADO, GLORIBELL (LCSW)
Entity Type:Individual
Prefix:
First Name:GLORIBELL
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-0512
Mailing Address - Country:US
Mailing Address - Phone:212-795-9888
Mailing Address - Fax:
Practice Address - Street 1:455 CENTRAL PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1034
Practice Address - Country:US
Practice Address - Phone:866-540-5279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0868661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical