Healthcare Provider Details

I. General information

NPI: 1285420638
Provider Name (Legal Business Name): MERCINA STEFANSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S WHITE HORSE PIKE # B
HAMMONTON NJ
08037-2014
US

IV. Provider business mailing address

167 YORKTOWN BLVD
HAMMONTON NJ
08037-2105
US

V. Phone/Fax

Practice location:
  • Phone: 609-214-7941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01132600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: