Provider Demographics
NPI:1255531406
Name:MERGE LLC
Entity type:Organization
Organization Name:MERGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:NOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-744-8422
Mailing Address - Street 1:5710 EXECUTIVE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1759
Mailing Address - Country:US
Mailing Address - Phone:410-744-8422
Mailing Address - Fax:410-744-8424
Practice Address - Street 1:5710 EXECUTIVE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1759
Practice Address - Country:US
Practice Address - Phone:410-744-8422
Practice Address - Fax:410-744-8424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty