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General NPI Number Information
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NPI Number | 1518035617
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Entity Type | Individual
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Provider Name | ANDREW JAY MERRITT LPC
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 2215 E. 21ST STREET
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City | TULSA, OK 74104
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State | OK
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Zip | 74104
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Country | US
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Telephone | 918-606-3536
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Fax |
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Provider Business Mailing Address
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Address Line | 1746 MELROSE DR 350 CENTER RD
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City | OZARK
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State | MO
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Zip | 65721
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Country | US
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Telephone | 918-606-3536
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0015803
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1602
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License Number State | OK
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