Provider Demographics
NPI:1205927357
Name:MERRICK, CARRIE ANN (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANN
Last Name:MERRICK
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 SOUTHERN HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-8984
Mailing Address - Country:US
Mailing Address - Phone:563-590-5862
Mailing Address - Fax:
Practice Address - Street 1:909 MAIN ST
Practice Address - Street 2:SUITE 505
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6712
Practice Address - Country:US
Practice Address - Phone:563-556-0699
Practice Address - Fax:563-583-3077
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health