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General NPI Number Information
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NPI Number | 1912646142
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Entity Type | Individual
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Provider Name | CASSANDRA MERRICK LPC
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Gender | Female
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Dates
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Enumeration Date | 06/04/2022
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 20 E TABB ST STE 205
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City | PETERSBURG
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State | VA
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Zip | 23803-4560
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Country | US
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Telephone | 804-536-5066
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Fax | 202-545-3413
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Provider Business Mailing Address
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Address Line | 20 E TABB ST STE 205
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City | PETERSBURG
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State | VA
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Zip | 23803-4560
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Country | US
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Telephone | 804-536-5066
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Fax | 202-545-3413
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | VA
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