Provider Demographics
NPI:1831243666
Name:MERCURIO CARE MANAGEMENT AND COUNSELING, INC.
Entity type:Organization
Organization Name:MERCURIO CARE MANAGEMENT AND COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MERCURIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:412-576-6104
Mailing Address - Street 1:2143 PAULINE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-3500
Mailing Address - Country:US
Mailing Address - Phone:412-576-6104
Mailing Address - Fax:
Practice Address - Street 1:2143 PAULINE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-3500
Practice Address - Country:US
Practice Address - Phone:412-576-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0137641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAME124877OtherHIGHMARK BLUE SHIELD
PA1015652150001Medicaid
PA1553077OtherGATEWAY MEDICARE ASSURED
PA1553077OtherGATEWAY MEDICARE ASSURED