Provider Demographics
NPI:1417053562
Name:MAY, MERILYN D (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MERILYN
Middle Name:D
Last Name:MAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068-1412
Mailing Address - Country:US
Mailing Address - Phone:815-562-5626
Mailing Address - Fax:
Practice Address - Street 1:1080 N 8TH ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068-1412
Practice Address - Country:US
Practice Address - Phone:815-562-5626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0007132002OtherLMFT