Provider Demographics
NPI:1306902473
Name:MERRETT-HALL, SHIRLEY DEANNA (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:DEANNA
Last Name:MERRETT-HALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:DEANNA
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:14798 SW 184TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1724
Mailing Address - Country:US
Mailing Address - Phone:305-253-5226
Mailing Address - Fax:305-253-5226
Practice Address - Street 1:99551 OVERSEAS HWY
Practice Address - Street 2:SUITE # 205
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4370
Practice Address - Country:US
Practice Address - Phone:305-453-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00033601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical