Provider Demographics
NPI:1538498167
Name:MERRITT, LINDSEY (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 US HIGHWAY 17 STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3397
Mailing Address - Country:US
Mailing Address - Phone:912-312-7409
Mailing Address - Fax:
Practice Address - Street 1:2451 US HIGHWAY 17 STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3397
Practice Address - Country:US
Practice Address - Phone:912-312-7409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-07-2393103K00000X
1-10-7598103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst