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General NPI Number Information
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NPI Number | 1487226544
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Entity Type | Individual
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Provider Name | MELYSSA MERCURIO PSY.D., NCSP, MT-BC
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Gender | Female
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 1350 OLD FREEPORT RD STE 1A
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City | PITTSBURGH
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State | PA
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Zip | 15238-3122
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Country | US
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Telephone | 412-406-7734
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Fax |
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Provider Business Mailing Address
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Address Line | 216 ALLEGHENY AVE
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City | KITTANNING
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State | PA
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Zip | 16201-1812
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Country | US
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Telephone | 716-628-5686
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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 | 225A00000X
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Taxonomy Name | Music Therapist
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License Number | 11899
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS019326
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License Number State | PA
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