NPI Code Detail JSON Logo

1366328635 NPI number — TERIKA TASHAE MERCEDES ED.D

NPI Number: 1366328635
Health Care Provider/Practitioner: TERIKA TASHAE MERCEDES ED.D

Information about “1366328635” NPI (TERIKA TASHAE MERCEDES ED.D) exists in 1366328635 in HTML format HTML  |  1366328635 in plain Text format TXT  |  1366328635 in PDF (Portable Document Format) PDF  |  1366328635 in an XML format XML  formats.

NPI Number : 1366328635 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1366328635",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MERCEDES",
    "FirstName": "TERIKA",
    "MiddleName": "TASHAE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "ED.D",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10380 SOUTH WEST VILLAGE DRIVE",
    "SecondLineMailingAddress": "302",
    "MailingAddressCityName": "PORT SAINT LUCIE, 34987",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34987",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-902-9244",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3801 SW CHICOPEE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORT ST LUCIE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34953-5373",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "847-902-9244",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/13/2025",
    "LastUpdateDate": "08/13/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "102L00000X",
          "TaxonomyName": "Psychoanalyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "172V00000X",
          "TaxonomyName": "Community Health Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TP2701X",
          "TaxonomyName": "Group Psychotherapy Psychologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171400000X",
          "TaxonomyName": "Health & Wellness Coach",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174H00000X",
          "TaxonomyName": "Health Educator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225XM0800X",
          "TaxonomyName": "Mental Health Occupational Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374K00000X",
          "TaxonomyName": "Religious Nonmedical Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP1600X",
          "TaxonomyName": "Pastoral Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "374T00000X",
          "TaxonomyName": "Religious Nonmedical Nursing Personnel",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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