Provider Demographics
NPI:1023337086
Name:SUSAN LLOYD-MERRICK PSYD LLC
Entity type:Organization
Organization Name:SUSAN LLOYD-MERRICK PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LLOYD-MERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:219-218-5224
Mailing Address - Street 1:336 CROOKED TREE TRL
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-1371
Mailing Address - Country:US
Mailing Address - Phone:219-218-5224
Mailing Address - Fax:
Practice Address - Street 1:336 CROOKED TREE TRL
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-1371
Practice Address - Country:US
Practice Address - Phone:219-218-5224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042376A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty