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NPI Code Detail

MEDICARE: DIANE K MERRELL LPC

MEDICARE:   DIANE K MERRELL  LPC
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
1101YP2500XProfessional Counselor7544NC

General Provider Information

NPI Number : 1730471327
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE K MERRELL LPC
Provider Business Mailing Address
First Line : 1905 J N PEASE PL
Second Line : SUITE 201
City : CHARLOTTE
State : NC
Zip : 28262-4557
Country : US
Telephone Number : 704-998-1781
Fax Number :
Provider Business Practice Location Address
First Line : 1905 J N PEASE PL
Second Line : SUITE 201
City : CHARLOTTE
State : NC
Zip : 28262-4557
Country : US
Telephone Number : 704-998-1781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2011
Last Update Date : 06/24/2011

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