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General NPI Number Information
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NPI Number | 1689891053
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Entity Type | Individual
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Provider Name | CAROLYN J MERRICK M.A./CAC III
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 650 E. MIAMI ST.
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City | MONTROSE
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State | CO
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Zip | 81402
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Country | US
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Telephone | 619-587-9162
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Fax | 970-249-2955
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Provider Business Mailing Address
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Address Line | 650 E. MIAMI ST.
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City | MONTROSE
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State | CO
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Zip | 81402
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Country | US
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Telephone | 970-497-8948
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Fax | 970-249-2955
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3601
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License Number State | CO
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