Individual provider Active NPI

Mercedes Kennedy, MA EDM LPC

  • Professional Counselor
  • Princeton, NJ
National Provider Identifier
1790944551
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00242300 Issued in NJ
Practice address
195 Nassau Street Office #28
Princeton, NJ 08542
Phone
(609) 683-1300
Fax
(609) 683-1361
NPI assigned
Jun 6, 2008
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00242300 NJ Primary

Addresses

Primary practice location

195 Nassau Street Office #28
Princeton, NJ 08542

Mailing address

195 Nassau Street Office #28
Princeton, NJ 08542
Phone (609) 683-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240304001125 NJ Practitioner - Mental Health Counselor 8426493131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Charities Diocese of TrentonGroup PAC ID 0345214466, 30 clinicians

Practice addresses (Care Compare)

39 N Clinton Ave
Trenton, NJ 08609-1011
Phone (609) 394-9398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities, Diocese of Trenton CurrentSince Jan 22, 2024 Accepting new patients

Locations

10 Southard St
Trenton, NJ 08609
Phone (609) 396-4557

383 W State St
Trenton, NJ 08618
Phone (609) 278-4933

39 N Clinton Ave
Trenton, NJ 08609
Phone (609) 394-5157

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1790944551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 NASSAU STREET OFFICE #28",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08542",
            "telephone_number": "609-683-1300",
            "fax_number": "609-683-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 NASSAU STREET OFFICE #28",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "08542",
            "telephone_number": "609-683-1300",
            "fax_number": "609-683-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MERCEDES",
        "name_prefix": "Ms.",
        "credential": "MA EDM LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00242300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.