Provider Demographics
NPI:1043404528
Name:YOUNT-MERRELL, KAREN (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:YOUNT-MERRELL
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12006 LAFAYETTE CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2130
Mailing Address - Country:US
Mailing Address - Phone:301-933-3423
Mailing Address - Fax:240-430-0443
Practice Address - Street 1:12006 LAFAYETTE CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2130
Practice Address - Country:US
Practice Address - Phone:301-933-3423
Practice Address - Fax:240-430-0443
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD059811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
B330 0001OtherBLUECROSS BLUESHIELD ID