Provider Demographics
NPI:1346913050
Name:MERRITT, LINDSAY NICOLE (PHD, LCSW)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:NICOLE
Last Name:MERRITT
Suffix:
Gender:
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 SE RICE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-4220
Mailing Address - Country:US
Mailing Address - Phone:503-891-2207
Mailing Address - Fax:
Practice Address - Street 1:1002 SE RICE AVE
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-4220
Practice Address - Country:US
Practice Address - Phone:503-891-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X, 1041C0700X
ORL122201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health