Provider Demographics
NPI:1922424597
Name:MERRILL, HOPE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:
Last Name:MERRILL
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 1:2319 BATESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHSIDE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7768
Mailing Address - Country:US
Mailing Address - Phone:870-834-2564
Mailing Address - Fax:
Practice Address - Street 1:2319 BATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHSIDE
Practice Address - State:AR
Practice Address - Zip Code:72501-7768
Practice Address - Country:US
Practice Address - Phone:870-834-2564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7043-M104100000X
AR7043-C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR228288719Medicaid
AR5BS85OtherBCBS