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General NPI Number Information
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NPI Number | 1366328635
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Entity Type | Individual
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Provider Name | TERIKA TASHAE MERCEDES ED.D
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Gender | Female
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 3801 SW CHICOPEE ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-5373
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Country | US
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Telephone | 847-902-9244
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Fax |
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Provider Business Mailing Address
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Address Line | 10380 SOUTH WEST VILLAGE DRIVE 302
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City | PORT SAINT LUCIE, 34987
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State | FL
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Zip | 34987
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Country | US
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Telephone | 847-902-9244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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Taxonomy #5
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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License Number |
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License Number State |
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