Provider Demographics
NPI:1043021231
Name:MERCADO, JAILYN
Entity type:Individual
Prefix:MS
First Name:JAILYN
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB BORINQUEN CALLE ANTONIO PEDREIRA F4
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3364
Mailing Address - Country:US
Mailing Address - Phone:939-264-6029
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 190
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681-0190
Practice Address - Country:US
Practice Address - Phone:787-831-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR169431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical