Provider Demographics
NPI:1851721104
Name:MERCADANTE, JENNA NICOLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:NICOLE
Last Name:MERCADANTE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 ATWATER DR STE 130
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-8782
Mailing Address - Country:US
Mailing Address - Phone:610-646-1851
Mailing Address - Fax:484-355-5181
Practice Address - Street 1:1200 ATWATER DR STE 130
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-8782
Practice Address - Country:US
Practice Address - Phone:610-646-1851
Practice Address - Fax:484-355-5181
Is Sole Proprietor?:No
Enumeration Date:2013-11-24
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017488103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist