Provider Demographics
NPI:1891816443
Name:MERZ, CRYSTAL (MSW BSW)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:MERZ
Suffix:
Gender:F
Credentials:MSW BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 ENDEAVOR LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WYLIE
Mailing Address - State:SC
Mailing Address - Zip Code:29710-6054
Mailing Address - Country:US
Mailing Address - Phone:704-965-1115
Mailing Address - Fax:
Practice Address - Street 1:2923 S TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5852
Practice Address - Country:US
Practice Address - Phone:704-965-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health