Provider Demographics
NPI:1770179756
Name:MERKLEIN, NATASHA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIE
Last Name:MERKLEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-4811
Mailing Address - Country:US
Mailing Address - Phone:512-843-1451
Mailing Address - Fax:
Practice Address - Street 1:3009 E 4TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4811
Practice Address - Country:US
Practice Address - Phone:512-843-1451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX556261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical