Carlene Mercury, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Philadelphia, PA
NPI 1043033004 · NPPES record last updated Nov 6, 2024
Key facts
- NPI
- 1043033004
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL017611 (PA)
- Practice address
- 1510 S 22ND St FL 1
Philadelphia, PA 19146-4201 - Phone
- (267) 438-5949
- NPI assigned
- Nov 6, 2024
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41YS01254000 | NJ | MD | Speech-Language Pathologist |
| SL017611 | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 41YS01254000 | NJ | |
| Speech-Language Pathologist | 235Z00000X | SL017611 | PA | Yes |
Addresses
Primary practice location
1510 S 22ND St FL 1
Philadelphia, PA 19146-4201
Mailing address
1510 S 22ND St FL 1
Philadelphia, PA 19146-4201
Phone (267) 438-5949
Other providers in Philadelphia, PA
- Elaina Rose Mercurio
- Juliana Mercurio
- Leana Elizabeth Mercurio
- Thomas C Mercurio
- Mercurius Home Care
- Mercy Catholic Medical Center of Southeastern PA
- Mercy Catholic Medical Center of Southeastern PA
- Mercy Catholic Medical Center of Southeastern PA
- Mercy Catholic Medical Center of Southeastern PA
- Mercy Catholic Medical Center of Southeastern PA
All providers in Philadelphia, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.