Provider Demographics
NPI:1992772834
Name:MERRITT, PATRICIA A (LCSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:MERRITT
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 1:173 HENNEPIN RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2322
Mailing Address - Country:US
Mailing Address - Phone:716-235-1922
Mailing Address - Fax:585-805-5126
Practice Address - Street 1:4955 N BAILEY AVE STE 100
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1206
Practice Address - Country:US
Practice Address - Phone:716-235-1922
Practice Address - Fax:585-805-5126
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07007111041C0700X
NY070071-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
00011249905OtherASO
160975538OtherMAGNA CARE
00011249905OtherSENIOR CHOICE
050725000032OtherFIDELIS FAMILY HEALTH PLU
00011249905OtherUNIVERA TRANSITIONS
00011249905OtherPLUS MED
00011249905OtherUNIVERA MEDICARE PPO
00011249905OtherCHILD HEALTH PLUS
NY01465154Medicaid
00011249905OtherUNIVERA COMMERCIAL
800010043OtherRAILROAD MEDICARE
00011249905OtherUNIVERA HEALTHCARE TRADIT
000590275001OtherBCBS WNY
050725000032OtherFIDELIS CHILD HEALTH PLUS
050725000032OtherFIDELIS MEDICAID
000590275001OtherBCBS WNY