Provider Demographics
NPI:1316067077
Name:MERRITT, LINDA KAY (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:MERRITT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 SARAH DR
Mailing Address - Street 2:
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-1234
Mailing Address - Country:US
Mailing Address - Phone:573-888-6608
Mailing Address - Fax:
Practice Address - Street 1:110 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-1922
Practice Address - Country:US
Practice Address - Phone:573-888-6608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000305101YP2500X
MO0034011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical