Provider Demographics
NPI:1477062040
Name:MEROLA, DARLA JEAN (LCDC III)
Entity Type:Individual
Prefix:MS
First Name:DARLA
Middle Name:JEAN
Last Name:MEROLA
Suffix:
Gender:F
Credentials:LCDC III
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 88
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-0088
Mailing Address - Country:US
Mailing Address - Phone:740-446-6471
Mailing Address - Fax:740-441-2970
Practice Address - Street 1:499 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1398
Practice Address - Country:US
Practice Address - Phone:740-446-6471
Practice Address - Fax:740-441-2970
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH121017101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty