Provider Demographics
NPI:1699810879
Name:MERKWAN, JOEL VINCENT (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:VINCENT
Last Name:MERKWAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 ABBOTT DR
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-5356
Mailing Address - Country:US
Mailing Address - Phone:605-661-6128
Mailing Address - Fax:
Practice Address - Street 1:327 BROADWAY AVE STE 15
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-7800
Practice Address - Country:US
Practice Address - Phone:605-661-6128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND393103TC0700X
SD490103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical