Provider Demographics
NPI:1528405842
Name:MERCADO, ROSA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 E HALSEY RD STE 354
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3709
Mailing Address - Country:US
Mailing Address - Phone:862-261-0694
Mailing Address - Fax:
Practice Address - Street 1:90 E HALSEY RD STE 354
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3709
Practice Address - Country:US
Practice Address - Phone:186-225-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00474700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional