MEDICARE: MERCEDES AND FAMILY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1063356756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCEDES AND FAMILY LLC

Provider Business Mailing Address
First Line	:	223 WESSINGTON AVE
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-2727
Country	:	US
Telephone Number	:	201-681-7497
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 WESSINGTON AVE
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-2727
Country	:	US
Telephone Number	:	201-681-7497
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BILLY MERCEDES
Credential	:	LPC, ACS, CHT, MA
Telephone Number	:	201-681-7497

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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