Active NPI
Charisse Mae P Mercado, ASW
- Clinical Social Worker
- Long Beach, CA
National Provider Identifier
1356534754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 62533
- Practice address
- 456 Elm Ave
Long Beach, CA 90802-2426 - Phone
- (562) 437-6717
- NPI assigned
- Aug 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 62533 | CA | Primary |
Addresses
Primary practice location
456 Elm Ave
Long Beach, CA 90802-2426
Mailing address
100 W. Broadway
Long Beach, CA 90802-2426
Phone (562) 285-1330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62533 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1356534754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W. BROADWAY",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908022426",
"telephone_number": "562-285-1330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 ELM AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908022426",
"telephone_number": "562-437-6717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCADO",
"first_name": "CHARISSE MAE",
"middle_name": "P",
"name_prefix": "Miss",
"credential": "ASW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "62533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.