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General NPI Number Information
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NPI Number | 1093598914
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Entity Type | Individual
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Provider Name | GREGORY SCOTT MERRILL LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 400 PARNASSUS AVE FL 7
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2202
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Country | US
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Telephone | 415-514-1966
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Fax |
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Provider Business Mailing Address
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Address Line | 666 THE ALAMEDA
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City | BERKELEY
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State | CA
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Zip | 94707-1640
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Country | US
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Telephone | 510-823-3379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19523
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License Number State | CA
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