Provider Demographics
NPI:1083984157
Name:MERRILL, TRENA ANN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:TRENA
Middle Name:ANN
Last Name:MERRILL
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 QUINCE ORCHARD BOULEVARD
Mailing Address - Street 2:#T2
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1740
Mailing Address - Country:US
Mailing Address - Phone:301-963-4615
Mailing Address - Fax:
Practice Address - Street 1:822 QUINCE ORCHARD BOULEVARD
Practice Address - Street 2:#T2
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1740
Practice Address - Country:US
Practice Address - Phone:301-963-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD057581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical