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General NPI Number Information
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NPI Number | 1619988797
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Entity Type | Individual
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Provider Name | SCOTT ADAM MERRITT M.A.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 16269 CONNEAUT LAKE RD SUITE 101
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City | MEADVILLE
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State | PA
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Zip | 16335-3887
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Country | US
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Telephone | 814-336-1011
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Fax | 814-333-4428
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Provider Business Mailing Address
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Address Line | PO BOX 558
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City | MEADVILLE
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State | PA
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Zip | 16335-0558
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Country | US
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Telephone | 814-336-1011
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Fax | 814-333-4428
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS006901-L
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License Number State | PA
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