Provider Demographics
NPI:1477951325
Name:MERRICK, CYNTHIA DAWN (LCSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DAWN
Last Name:MERRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:NUTWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1869 WOODPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2876
Mailing Address - Country:US
Mailing Address - Phone:812-480-3768
Mailing Address - Fax:
Practice Address - Street 1:145 HOWARD LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-1848
Practice Address - Country:US
Practice Address - Phone:404-960-0328
Practice Address - Fax:855-817-2428
Is Sole Proprietor?:No
Enumeration Date:2014-12-09
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical