Provider Demographics
NPI:1750053658
Name:MERYL, ADRIENNE (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:MERYL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:MERYL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7600 N 15TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4305
Mailing Address - Country:US
Mailing Address - Phone:718-702-4164
Mailing Address - Fax:
Practice Address - Street 1:7600 N 15TH ST STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-4305
Practice Address - Country:US
Practice Address - Phone:718-702-4164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical