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NPI Code Detail

MEDICARE: CASEY JEAN MERRILL LCSW

MEDICARE:   CASEY JEAN MERRILL  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
11041C0700XClinical Social Worker011087CT

General Provider Information

NPI Number : 1649850793
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY JEAN MERRILL LCSW
Provider Business Mailing Address
First Line : 227 CHURCH ST APT 1J
Second Line :
City : NEW HAVEN
State : CT
Zip : 06510-1826
Country : US
Telephone Number : 269-757-4360
Fax Number :
Provider Business Practice Location Address
First Line : 3013 DIXWELL AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-3527
Country : US
Telephone Number : 203-399-6071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2021
Last Update Date : 04/13/2021

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Directions to “ CASEY JEAN MERRILL LCSW” Practice Location

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