Provider Demographics
NPI:1699943225
Name:MERCADO CEREZO, HAYDEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:HAYDEE
Middle Name:
Last Name:MERCADO CEREZO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:HAYDEE
Other - Middle Name:
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2136 33RD RD APT 4B
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4230
Mailing Address - Country:US
Mailing Address - Phone:917-579-2683
Mailing Address - Fax:
Practice Address - Street 1:2136 33RD RD APT 4B
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4230
Practice Address - Country:US
Practice Address - Phone:917-579-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-17
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072848-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical