Healthcare Provider Details

I. General information

NPI: 1184756413
Provider Name (Legal Business Name): THOMAS ANDREW MERZ LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 INTERNATIONAL PARKWAY
ADAIRSVILLE GA
30103-2025
US

IV. Provider business mailing address

PO BOX 388
ADAIRSVILLE GA
30103-0388
US

V. Phone/Fax

Practice location:
  • Phone: 770-773-3653
  • Fax: 770-773-3655
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2850
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: