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General NPI Number Information
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NPI Number | 1144535147
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Entity Type | Individual
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Provider Name | CARRIE LORE MERCADO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 1516 HETHER ST UNIT A
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City | AUSTIN
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State | TX
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Zip | 78704-3312
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Country | US
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Telephone | 512-843-1904
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 HETHER ST UNIT A
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City | AUSTIN
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State | TX
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Zip | 78704-3312
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Country | US
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Telephone | 513-843-1904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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