Provider Demographics
NPI:1831308436
Name:LOVE, MERRY CHARLENE (MS,LPC,LMFT)
Entity Type:Individual
Prefix:MS
First Name:MERRY
Middle Name:CHARLENE
Last Name:LOVE
Suffix:
Gender:F
Credentials:MS,LPC,LMFT
Other - Prefix:MRS
Other - First Name:CHARLIE
Other - Middle Name:
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC, LMFT
Mailing Address - Street 1:7705 MOWINKLE CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78736-7944
Mailing Address - Country:US
Mailing Address - Phone:512-327-8196
Mailing Address - Fax:512-288-2891
Practice Address - Street 1:7705 MOWINKLE CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78736-7944
Practice Address - Country:US
Practice Address - Phone:512-327-8196
Practice Address - Fax:512-288-2891
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist