MEDICARE: NATALIE MERRICK THERAPY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1417735077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATALIE MERRICK THERAPY, PLLC

Provider Business Mailing Address
First Line	:	2439 N TALMAN AVE APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6079
Country	:	US
Telephone Number	:	802-558-8832
Fax Number	:

Provider Business Practice Location Address
First Line	:	2439 N TALMAN AVE APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6079
Country	:	US
Telephone Number	:	802-558-8832
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND SOLE MEMBER
Name	:	NATALIE MERRICK
Credential	:	LCSW
Telephone Number	:	802-558-8832

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	09/15/2023

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