Provider Demographics
NPI:1730601386
Name:MERCEDES, ALICIA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:MERCEDES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:MARLIEB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1764 MAPLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3805
Mailing Address - Country:US
Mailing Address - Phone:954-818-5750
Mailing Address - Fax:
Practice Address - Street 1:2900 N UNIVERSITY DR # 67
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5083
Practice Address - Country:US
Practice Address - Phone:954-818-5750
Practice Address - Fax:888-245-9698
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15207101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional