Provider Demographics
NPI:1396735932
Name:SLICK, MERRI BARTON (LCSW)
Entity type:Individual
Prefix:MS
First Name:MERRI
Middle Name:BARTON
Last Name:SLICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5188 MILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-6316
Mailing Address - Country:US
Mailing Address - Phone:678-493-2462
Mailing Address - Fax:
Practice Address - Street 1:1701 HARDEE AVE SW
Practice Address - Street 2:
Practice Address - City:FT MCPHERSON
Practice Address - State:GA
Practice Address - Zip Code:30330-1062
Practice Address - Country:US
Practice Address - Phone:404-464-2200
Practice Address - Fax:404-464-4764
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0033421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical