Healthcare Provider Details

I. General information

NPI: 1194649806
Provider Name (Legal Business Name): MIGDALIA MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 S ORANGE AVE
NEWARK NJ
07103-2757
US

IV. Provider business mailing address

1256 CRESCENT AVE
ROSELLE NJ
07203-2944
US

V. Phone/Fax

Practice location:
  • Phone: 800-969-5300
  • Fax:
Mailing address:
  • Phone: 908-538-8691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: