Provider Demographics
NPI:1164112884
Name:BECKFORD-ANDERSON, MERCEDES
Entity Type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:
Last Name:BECKFORD-ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 MUSTANG LAKE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-7961
Mailing Address - Country:US
Mailing Address - Phone:281-972-5565
Mailing Address - Fax:
Practice Address - Street 1:1423 MUSTANG LAKE CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7961
Practice Address - Country:US
Practice Address - Phone:281-972-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104437104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker