Healthcare Provider Details

I. General information

NPI: 1215623863
Provider Name (Legal Business Name): CASSANDRA MERCURI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 BUSH PKWY
EAST BRUNSWICK NJ
08816-2208
US

IV. Provider business mailing address

9 BUSH PKWY
E BRUNSWICK NJ
08816-2208
US

V. Phone/Fax

Practice location:
  • Phone: 732-239-7436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37AC00529900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00529900
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37AC00529900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: