Healthcare Provider Details

I. General information

NPI: 1275410946
Provider Name (Legal Business Name): ANNA LOUISE CITLALI MERCIER CASAC-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2025
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 LEXINGTON AVE RM 14A
NEW YORK NY
10017-6526
US

IV. Provider business mailing address

80 5TH AVE FL 6
NEW YORK NY
10011-8002
US

V. Phone/Fax

Practice location:
  • Phone: 212-204-8430
  • Fax: 212-600-1294
Mailing address:
  • Phone: 516-261-2368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: