Provider Demographics
NPI:1396398335
Name:E. MERCEDES CONSULTING AND SERVICES
Entity type:Organization
Organization Name:E. MERCEDES CONSULTING AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ENMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCEDES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-841-4486
Mailing Address - Street 1:38 KNOLL TER
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7306
Mailing Address - Country:US
Mailing Address - Phone:201-953-9074
Mailing Address - Fax:
Practice Address - Street 1:526 BLOOMFIELD AVE STE 204
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006
Practice Address - Country:US
Practice Address - Phone:973-841-4486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty