Provider Demographics
NPI:1013345487
Name:MERCADO, LUZ OMAYRA (MSW)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:OMAYRA
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:PO BOX 654
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-0654
Mailing Address - Country:US
Mailing Address - Phone:787-426-6221
Mailing Address - Fax:939-697-6054
Practice Address - Street 1:CARR. LUIS MUNOZ RIVERA 48 SUITE 10
Practice Address - Street 2:CENTRO PLAZA LEONARDO AVILES
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-930-0836
Practice Address - Fax:800-280-5358
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR114301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical