Individual provider Active NPI

Ceta Michaela Mercadal, LPC

  • Mental Health Counselor
  • Denver, CO
National Provider Identifier
1174058911
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0015109 Issued in CO
Practice address
4140 Tejon St
Denver, CO 80211-1813
Phone
(720) 507-8815
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC.0015109 CO Primary

Addresses

Primary practice location

4140 Tejon St
Denver, CO 80211-1813

Mailing address

8700 E Jefferson Ave
#370993
Denver, CO 80237-9998
Phone (720) 507-8815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029002494 CO Practitioner - Mental Health Counselor 2668905613 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0015109COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Free Yourself LLC Mental Health CurrentSince Oct 16, 2024 Accepting new patients

Locations

4140 Tejon St
Denver, CO 80211
Phone (720) 319-7893

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1174058911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 E JEFFERSON AVE",
            "address_2": "#370993",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802379998",
            "telephone_number": "720-507-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 TEJON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802111813",
            "telephone_number": "720-507-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADAL",
        "first_name": "CETA",
        "middle_name": "MICHAELA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0015109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.