Provider Demographics
NPI:1427768761
Name:MERISMOS COUNSELING SERVICES
Entity type:Organization
Organization Name:MERISMOS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIELDS-WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC ( LICENSED COUN
Authorized Official - Phone:937-360-8818
Mailing Address - Street 1:1543 NOEL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45506-2511
Mailing Address - Country:US
Mailing Address - Phone:937-360-8818
Mailing Address - Fax:
Practice Address - Street 1:1543 NOEL DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45506-2511
Practice Address - Country:US
Practice Address - Phone:937-360-8818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0216276Medicaid