Provider Demographics
NPI:1275974289
Name:MERRYFIELD, CARLYE (LMSW)
Entity Type:Individual
Prefix:
First Name:CARLYE
Middle Name:
Last Name:MERRYFIELD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 860764
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66286-0764
Mailing Address - Country:US
Mailing Address - Phone:816-836-2920
Mailing Address - Fax:
Practice Address - Street 1:8806 W 49TH TER
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66203-1712
Practice Address - Country:US
Practice Address - Phone:816-836-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX569051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical