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NPI Code Detail

MEDICARE: MERRITT BENZ LCSW

MEDICARE: MERRITT BENZ LCSW
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
1101YM0800XMental Health Counselor2012029758MO

General Provider Information

NPI Number : 1992124911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERRITT BENZ LCSW
Provider Business Mailing Address
First Line : 4044 CENTRAL ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-2228
Country : US
Telephone Number : 816-659-5264
Fax Number :
Provider Business Practice Location Address
First Line : 4044 CENTRAL ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-2228
Country : US
Telephone Number : 816-659-5264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2014
Last Update Date : 04/08/2014

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Directions to “ MERRITT BENZ LCSW” Practice Location

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