Larissa Suzette Mercado Jimenez, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6834 Issued in PR

Practice address

445 Ave Gonzalez Clemente Ste 215
Mayaguez, PR 00682-1107

Phone

(939) 525-3222

NPI assigned

Jun 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1992373716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 AVE GONZALEZ CLEMENTE STE 304",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006821107",
            "telephone_number": "787-560-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 AVE GONZALEZ CLEMENTE STE 215",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006821107",
            "telephone_number": "939-525-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO JIMENEZ",
        "first_name": "LARISSA",
        "middle_name": "SUZETTE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-11-03",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PR",
            "license": "6834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yamilitza Mendez
• Aida Del C Mendoza Rodriguez
• Menteviva LLC
• Frantony Mercado Cabrera, MD
• Mercado Dermatology LLC
• Hector Roman Mercado Ramirez, MD
• Rogelio Mercado-Seda, MD
• Awdelyn Mercado, PHARM D
• Elizabeth Mercado
• Erika Mercado, PA

• Clinical Psychologist in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Clinical Psychologist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.