Provider Demographics
NPI:1699271544
Name:MERKEL, JENNIFER (CSW-I)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MERKEL
Suffix:
Gender:F
Credentials:CSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 SUTTON HILLS PL
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9745
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:526 S TONOPAH DR STE 140-160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4043
Practice Address - Country:US
Practice Address - Phone:702-440-8440
Practice Address - Fax:866-518-0781
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NV8159-M104100000X
NVIC-1780104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst