Provider Demographics
NPI:1144415092
Name:MERRITT, MCCRAE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MCCRAE
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MCCRAE
Other - Middle Name:
Other - Last Name:LIGHTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1322 N. ACADEMY BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3320
Mailing Address - Country:US
Mailing Address - Phone:719-332-8090
Mailing Address - Fax:866-678-4596
Practice Address - Street 1:1322 N. ACADEMY BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3320
Practice Address - Country:US
Practice Address - Phone:719-332-8090
Practice Address - Fax:866-678-4596
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4726101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional