MEDICARE: ALBERT W MERCHANT 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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker	11549	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649382938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT W MERCHANT LCSW

Provider Business Mailing Address
First Line	:	10300 N. CENTRAL EXPWY
Second Line	:	STE 203
City	:	DALLAS
State	:	TX
Zip	:	75231-8600
Country	:	US
Telephone Number	:	214-503-9222
Fax Number	:	214-503-7788

Provider Business Practice Location Address
First Line	:	10300 N. CENTRAL EXPWY
Second Line	:	STE 203
City	:	DALLAS
State	:	TX
Zip	:	75231-8600
Country	:	US
Telephone Number	:	214-503-9222
Fax Number	:	214-503-7788

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/10/2012

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Directions to “ ALBERT W MERCHANT LCSW” Practice Location

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