Healthcare Provider Details

I. General information

NPI: 1225457237
Provider Name (Legal Business Name): MARILOU MERRINGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARILOU INGLES

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 ARNOLD DR
LITTLE ROCK AIR FORCE BASE AR
72099-4933
US

IV. Provider business mailing address

1090 ARNOLD DR
LITTLE ROCK AIR FORCE BASE AR
72099-4933
US

V. Phone/Fax

Practice location:
  • Phone: 501-987-7338
  • Fax:
Mailing address:
  • Phone: 501-987-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2016022474
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: