Provider Demographics
NPI:1497469423
Name:MERRITT, BREONA MICHELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:BREONA
Middle Name:MICHELLE
Last Name:MERRITT
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 1:13201 NW FWY STE 660
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-0004
Mailing Address - Country:US
Mailing Address - Phone:832-358-5767
Mailing Address - Fax:
Practice Address - Street 1:13201 NW FWY STE 660
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-0004
Practice Address - Country:US
Practice Address - Phone:832-358-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105363104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker