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General NPI Number Information
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NPI Number | 1588392112
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Entity Type | Organization
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Legal Business Name | DENNIS L MERRITT LCSW PHD SC
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 6110 N PORT WASHINGTON RD
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City | GLENDALE
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State | WI
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Zip | 53217-4308
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Country | US
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Telephone | 414-828-8847
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Fax |
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Provider Business Mailing Address
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Address Line | 2963 N PROSPECT AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-3345
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Country | US
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Telephone | 414-828-8847
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DENNIS L. MERRITT
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Credential | LCSW
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Telephone | 414-828-8847
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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 |
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License Number State |
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