MEDICARE: RABERTA JAMY DEMERCURIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	126943-01	NY
2	104100000X	Social Worker	17733	SC

General Provider Information

NPI Number	:	1982493169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RABERTA JAMY DEMERCURIO

Provider Business Mailing Address
First Line	:	3675 CLAYPOND RD UNIT H
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-7389
Country	:	US
Telephone Number	:	843-286-9157
Fax Number	:

Provider Business Practice Location Address
First Line	:	3675 CLAYPOND RD UNIT H
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-7389
Country	:	US
Telephone Number	:	843-286-9157
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	09/29/2025

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Directions to “ RABERTA JAMY DEMERCURIO ” Practice Location

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