Provider Demographics
NPI:1124141320
Name:MERRITT, NATHAN DEE (LICSW)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:DEE
Last Name:MERRITT
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:TN
Mailing Address - Zip Code:38011-8606
Mailing Address - Country:US
Mailing Address - Phone:901-494-1849
Mailing Address - Fax:901-874-2763
Practice Address - Street 1:176 DOGWOOD DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:TN
Practice Address - Zip Code:38011-8606
Practice Address - Country:US
Practice Address - Phone:901-494-1849
Practice Address - Fax:901-874-2763
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3010031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical