Provider Demographics
NPI:1295137412
Name:MERRIN, MARIAM OPINCAR (MA, LMHC, CDPT)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:OPINCAR
Last Name:MERRIN
Suffix:
Gender:F
Credentials:MA, LMHC, CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 172ND ST SW
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-3024
Mailing Address - Country:US
Mailing Address - Phone:206-486-0242
Mailing Address - Fax:
Practice Address - Street 1:1107 NE 45TH ST
Practice Address - Street 2:STE 410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4690
Practice Address - Country:US
Practice Address - Phone:206-486-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60463233101YM0800X
WALH 60675467101YM0800X
WACO 60516023101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)