Provider Demographics
NPI:1821711060
Name:RUIZ MERCADO, JANELIZ (CSW)
Entity Type:Individual
Prefix:
First Name:JANELIZ
Middle Name:
Last Name:RUIZ MERCADO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB LAGO HORIZONTE
Mailing Address - Street 2:4010 CALLE AMBAR
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-955-1554
Mailing Address - Fax:
Practice Address - Street 1:URB LAGO HORIZONTE
Practice Address - Street 2:4010 CALLE AMBAR
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-955-1554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR158221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical