Provider Demographics
NPI:1790886877
Name:MERRILL FACIO, MARIA VIRGINIA (LMHC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VIRGINIA
Last Name:MERRILL FACIO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:VIRGINIA
Other - Last Name:MARTEGANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:3002 NW 99TH PL
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1047
Mailing Address - Country:US
Mailing Address - Phone:615-336-0847
Mailing Address - Fax:
Practice Address - Street 1:3002 NW 99TH PL
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1047
Practice Address - Country:US
Practice Address - Phone:615-336-0847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH21260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health