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General NPI Number Information
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NPI Number | 1477562387
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Entity Type | Individual
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Provider Name | CHRISTOPHER RAY MERRELL M.A., LPC, CTRS
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 1106 SANTE FE TRAIL SUITE 3
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City | DUNCANVILLE
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State | TX
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Zip | 75137-3063
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Country | US
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Telephone | 469-337-1160
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Fax | 972-218-7754
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Provider Business Mailing Address
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Address Line | 1106 SANTE FE TRAIL SUITE 3
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City | DUNCANVILLE
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State | TX
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Zip | 75137-3063
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Country | US
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Telephone | 469-337-1160
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Fax | 972-218-7754
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 60363
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number | 40746
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License Number State | TX
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