Healthcare Provider Details

I. General information

NPI: 1215691878
Provider Name (Legal Business Name): CARLOS FRANCISCO MERCEDES MERAN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 5TH AVE FL 12
NEW YORK NY
10011-5608
US

IV. Provider business mailing address

1216 BRIARWOOD DR
ELKHART IN
46514-4488
US

V. Phone/Fax

Practice location:
  • Phone: 347-369-4302
  • Fax:
Mailing address:
  • Phone: 765-372-0426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number016842
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: