Provider Demographics
NPI:1609529452
Name:MERCADO, CIERRIA JANEESE
Entity Type:Individual
Prefix:MRS
First Name:CIERRIA
Middle Name:JANEESE
Last Name:MERCADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 CARROT PATCH DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-7101
Mailing Address - Country:US
Mailing Address - Phone:704-497-0316
Mailing Address - Fax:
Practice Address - Street 1:2300 SARDIS RD N STE MN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7715
Practice Address - Country:US
Practice Address - Phone:704-344-0491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0169861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical