Provider Demographics
NPI:1851345276
Name:MERCATANTE, ALFONSE L (MED, LPCMH)
Entity Type:Individual
Prefix:
First Name:ALFONSE
Middle Name:L
Last Name:MERCATANTE
Suffix:
Gender:M
Credentials:MED, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 KIRKWOOD HWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7268
Mailing Address - Country:US
Mailing Address - Phone:302-368-0842
Mailing Address - Fax:302-368-0846
Practice Address - Street 1:2644 KIRKWOOD HWY
Practice Address - Street 2:SUITE 260
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7268
Practice Address - Country:US
Practice Address - Phone:302-368-0842
Practice Address - Fax:302-368-0846
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-00001101YM0800X
MDLC-0209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health