Provider Demographics
NPI:1306395637
Name:MERRITT, CATHY (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:80 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-7237
Mailing Address - Country:US
Mailing Address - Phone:404-702-8066
Mailing Address - Fax:
Practice Address - Street 1:245 COUNTRY CLUB DR BLDG 300B
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7213
Practice Address - Country:US
Practice Address - Phone:678-284-1008
Practice Address - Fax:678-284-1009
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN172732363LF0000X
GA2021182877363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily