Provider Demographics
NPI:1790409993
Name:MERCADO, LIZMARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:LIZMARIE
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. BRISAS DEL MAR CALLE MAR ROJO
Mailing Address - Street 2:#87
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3381
Mailing Address - Country:US
Mailing Address - Phone:787-669-7921
Mailing Address - Fax:
Practice Address - Street 1:URB. BRISAS DEL MAR CALLE MAR ROJO
Practice Address - Street 2:#87
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-669-7921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR248541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical