Healthcare Provider Details

I. General information

NPI: 1043325921
Provider Name (Legal Business Name): ANNE ELISE MERICAL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32828 REBA ROAD SUITE A
MILLVILLE DE
19967
US

IV. Provider business mailing address

36541 WILD ROSE CIRCLE
SELBYVILLE DE
19975
US

V. Phone/Fax

Practice location:
  • Phone: 724-454-0810
  • Fax: 302-564-7465
Mailing address:
  • Phone: 724-454-0810
  • Fax: 302-564-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW012318L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001616
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: