Provider Demographics
NPI:1659132488
Name:MERCADO, ANASTASIA G (LCPC)
Entity type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:G
Last Name:MERCADO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 ARD BRAC PL
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-9167
Mailing Address - Country:US
Mailing Address - Phone:443-760-7165
Mailing Address - Fax:
Practice Address - Street 1:1401 ARD BRAC PL
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-9167
Practice Address - Country:US
Practice Address - Phone:443-760-7165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC16624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional