Provider Demographics
NPI:1629336912
Name:MERRILL POWERS, MSW, LCSW, PC
Entity Type:Organization
Organization Name:MERRILL POWERS, MSW, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRILL
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-852-5066
Mailing Address - Street 1:642 OAKHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-4030
Mailing Address - Country:US
Mailing Address - Phone:530-852-5066
Mailing Address - Fax:530-888-8793
Practice Address - Street 1:101 ORANGE ST
Practice Address - Street 2:SUITE B
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5232
Practice Address - Country:US
Practice Address - Phone:530-852-5066
Practice Address - Fax:530-888-8793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 194511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty