Provider Demographics
NPI:1174058911
Name:MERCADAL, CETA MICHAELA (LPC)
Entity type:Individual
Prefix:
First Name:CETA
Middle Name:MICHAELA
Last Name:MERCADAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 E JEFFERSON AVE
Mailing Address - Street 2:#370993
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-9998
Mailing Address - Country:US
Mailing Address - Phone:720-507-8815
Mailing Address - Fax:
Practice Address - Street 1:4140 TEJON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-1813
Practice Address - Country:US
Practice Address - Phone:720-507-8815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health