Provider Demographics
NPI:1629178207
Name:MCCARTER, MERRILL L (LCSW, ACSW, BCD)
Entity Type:Individual
Prefix:
First Name:MERRILL
Middle Name:L
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:LCSW, ACSW, BCD
Other - Prefix:
Other - First Name:MERRILL
Other - Middle Name:L
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1894
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22195-1894
Mailing Address - Country:US
Mailing Address - Phone:703-491-7072
Mailing Address - Fax:
Practice Address - Street 1:14904 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 403
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-491-7072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2011-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040001741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA132124OtherMHN
VA8909849Medicaid
VAA086091OtherVALUE OPTIONS, INC.
VA351588PPOOtherNCPPO
VA049289OtherANTHEM BC/BS
VAA369OtherGHMSI
VA8909849Medicaid