Maybelle E Mercado, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001795 Issued in CT

Practice address

836 Farmington Ave Ste 219
West Hartford, CT 06119-1545

Phone

(860) 909-0811

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fair Haven Community Health Clinic IncGroup PAC ID 4183511538, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Fair Haven Community Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1104803444
  Medicare reassignment Care Compare group NPD
• Fair Haven Community Health Clinic, Inc

  dba Grand Pharmacy

  • Community/Retail Pharmacy
  • Branford, CT
  • NPI 1760051486
  NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1851432355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MERRIGAN LN",
            "city": "WINDSOR LOCKS",
            "state": "CT",
            "postal_code": "060961573",
            "telephone_number": "860-593-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 FARMINGTON AVE STE 219",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191545",
            "telephone_number": "860-909-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "MAYBELLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4856",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysse Melville, L.C.S.W.
• Mendelson Chiropractic LLC (Essential Health)
• Allison Mendelson, D.C.
• Mental Serenity Psychiatric Services PLLC
• Olivia Menzel, OTR/L, CHT
• Paula V. Mercado
• Mercy Community Homecare Services, Inc
• Mercyknoll, Inc
• Caitlin Merriman, L.C.S.W
• George E. Messer, D.M.D.

• Professional Counselor in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.