Provider Demographics
NPI:1508293036
Name:RICHARDS, MARY MERCEDES
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:MERCEDES
Last Name:RICHARDS
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 1:808 9TH ST # 101
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5140
Mailing Address - Country:US
Mailing Address - Phone:817-919-5518
Mailing Address - Fax:
Practice Address - Street 1:808 9TH ST # 101
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5140
Practice Address - Country:US
Practice Address - Phone:817-919-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health