MEDICARE: CECILIA MARIE MERCURIO LMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MC61586909	WA

General Provider Information

NPI Number	:	1437970209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA MARIE MERCURIO LMHCA

Provider Business Mailing Address
First Line	:	2442 NW MARKET ST UNIT 865
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4137
Country	:	US
Telephone Number	:	360-326-2942
Fax Number	:

Provider Business Practice Location Address
First Line	:	2442 NW MARKET ST UNIT 865
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-4137
Country	:	US
Telephone Number	:	360-326-2942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	11/01/2024

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