Provider Demographics
NPI:1730457128
Name:MERCADO, MARIA SOCCI (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:SOCCI
Last Name:MERCADO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:SOCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1931 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3506
Mailing Address - Country:US
Mailing Address - Phone:203-384-8681
Mailing Address - Fax:
Practice Address - Street 1:2900 MAIN ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4946
Practice Address - Country:US
Practice Address - Phone:203-378-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0055061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical