MEDICARE: CYNTHIA DAWN MERRICK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1477951325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA DAWN MERRICK LCSW

Provider Business Mailing Address
First Line	:	1869 WOODPOINTE DR
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-2876
Country	:	US
Telephone Number	:	812-480-3768
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 HOWARD LN
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30215-1848
Country	:	US
Telephone Number	:	404-960-0328
Fax Number	:	855-817-2428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	05/01/2023

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