Provider Demographics
NPI:1952874679
Name:CABRERA MERCEDES, JORGE CABRERA
Entity Type:Individual
Prefix:MR
First Name:JORGE
Middle Name:CABRERA
Last Name:CABRERA MERCEDES
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JORGE
Other - Middle Name:
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2801 PARK CENTER DR APT 1001
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1423
Mailing Address - Country:US
Mailing Address - Phone:617-631-6925
Mailing Address - Fax:
Practice Address - Street 1:502 KENNEDY ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3010
Practice Address - Country:US
Practice Address - Phone:202-313-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health