Provider Demographics
NPI:1992715353
Name:MERCADANTE, DINA MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:MARIE
Last Name:MERCADANTE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-4957
Mailing Address - Country:US
Mailing Address - Phone:941-744-0933
Mailing Address - Fax:
Practice Address - Street 1:2328 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-5432
Practice Address - Country:US
Practice Address - Phone:941-744-0933
Practice Address - Fax:941-747-1093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2121956659001OtherBEECHSTREET PROVIDER #
FL258983OtherCOMPSYCH PROVIDER #
FLZ002VOtherBCBS PROVIDER #
FL238680OtherAMERIGROUP PROVIDER #