Provider Demographics
NPI:1447052071
Name:LEDESMA MONTAS, MERCEDES MARIANA (LCSW)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:MARIANA
Last Name:LEDESMA MONTAS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4329 O ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-6105
Mailing Address - Country:US
Mailing Address - Phone:267-701-3300
Mailing Address - Fax:
Practice Address - Street 1:45 E CITY AVE # 1686
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2421
Practice Address - Country:US
Practice Address - Phone:267-701-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0256461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical