Provider Demographics
NPI:1508913690
Name:MERRICK, LORENSITA F (LADC)
Entity Type:Individual
Prefix:MRS
First Name:LORENSITA
Middle Name:F
Last Name:MERRICK
Suffix:
Gender:F
Credentials:LADC
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 250
Mailing Address - Street 2:
Mailing Address - City:MACY
Mailing Address - State:NE
Mailing Address - Zip Code:68039-0250
Mailing Address - Country:US
Mailing Address - Phone:402-837-5381
Mailing Address - Fax:402-837-5271
Practice Address - Street 1:100 INDIAN HILLS DR
Practice Address - Street 2:
Practice Address - City:MACY
Practice Address - State:NE
Practice Address - Zip Code:68039-3023
Practice Address - Country:US
Practice Address - Phone:402-837-5381
Practice Address - Fax:402-837-5271
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-561101Y00000X
NE1036101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor