Provider Demographics
NPI:1437386810
Name:MERRYMAN, DAYNA (MDIV, LCSW)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:
Last Name:MERRYMAN
Suffix:
Gender:F
Credentials:MDIV, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 BUFORD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-1158
Mailing Address - Country:US
Mailing Address - Phone:717-339-6377
Mailing Address - Fax:
Practice Address - Street 1:395 BUFORD AVE STE 2
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1158
Practice Address - Country:US
Practice Address - Phone:717-339-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA886515328104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025597690001Medicaid