Provider Demographics
NPI:1609285543
Name:MERRILY NEILL, LCSW
Entity Type:Organization
Organization Name:MERRILY NEILL, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRILY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-237-1043
Mailing Address - Street 1:7 TEAKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9356
Mailing Address - Country:US
Mailing Address - Phone:919-237-1043
Mailing Address - Fax:
Practice Address - Street 1:7 TEAKWOOD CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9356
Practice Address - Country:US
Practice Address - Phone:919-237-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC000017501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty