Individual provider Active NPI

Graciosa Mercedes Mercedes de Cabral, LPMHC

  • Mental Health Counselor
  • Woodside, NY
National Provider Identifier
1477161339
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
100097-01 Issued in NY
Practice address
6120 Woodside Ave
Woodside, NY 11377-3577
Phone
(718) 672-1705
NPI assigned
Jul 16, 2020
Last updated
Jul 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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 100097-01 NY Primary

Addresses

Primary practice location

6120 Woodside Ave
Woodside, NY 11377-3577

Mailing address

966 E 181St St Apt 1B
Bronx, NY 10460-2280
Phone (347) 758-8080

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

LicenseStateTypeSpecialty
100097-01NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1477161339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 E 181ST ST APT 1B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104602280",
            "telephone_number": "347-758-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 WOODSIDE AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773577",
            "telephone_number": "718-672-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCEDES DE CABRAL",
        "first_name": "GRACIOSA",
        "middle_name": "MERCEDES",
        "credential": "LPMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "100097-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.