Provider Demographics
NPI:1194063305
Name:DAN MERTIG CONSULTING LLC
Entity type:Organization
Organization Name:DAN MERTIG CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERTIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-373-6348
Mailing Address - Street 1:38 BIMINI DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-7205
Mailing Address - Country:US
Mailing Address - Phone:912-373-6348
Mailing Address - Fax:
Practice Address - Street 1:38 BIMINI DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-7205
Practice Address - Country:US
Practice Address - Phone:912-373-6348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006834251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health