Provider Demographics
| NPI: | 1366328635 |
|---|---|
| Name: | MERCEDES, TERIKA TASHAE (EDD) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | TERIKA |
| Middle Name: | TASHAE |
| Last Name: | MERCEDES |
| Suffix: | |
| Gender: | F |
| Credentials: | EDD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 10380 SOUTH WEST VILLAGE DRIVE |
| Mailing Address - Street 2: | 302 |
| Mailing Address - City: | PORT SAINT LUCIE, 34987 |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 34987 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 847-902-9244 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 3801 SW CHICOPEE ST |
| Practice Address - Street 2: | |
| Practice Address - City: | PORT ST LUCIE |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 34953-5373 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 847-902-9244 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2025-08-13 |
| Last Update Date: | 2025-08-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 101YP1600X | Behavioral Health & Social Service Providers | Counselor | Pastoral |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
| No | 102L00000X | Behavioral Health & Social Service Providers | Psychoanalyst | |
| No | 172V00000X | Other Service Providers | Community Health Worker | |
| No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
| No | 171400000X | Other Service Providers | Health & Wellness Coach | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
| No | 174H00000X | Other Service Providers | Health Educator | |
| No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 374K00000X | Nursing Service Related Providers | Religious Nonmedical Practitioner | |
| No | 374T00000X | Nursing Service Related Providers | Religious Nonmedical Nursing Personnel |
