Provider Demographics
NPI:1811904782
Name:MERZ-STAVIS, DENISE MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MARIE
Last Name:MERZ-STAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5242 ROPER AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3812
Mailing Address - Country:US
Mailing Address - Phone:916-961-0529
Mailing Address - Fax:916-961-3640
Practice Address - Street 1:7509 MADISON AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7467
Practice Address - Country:US
Practice Address - Phone:916-961-0529
Practice Address - Fax:916-961-3640
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS16852101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA049998OtherPRACTIONER ID NUMBER MHN
CA049998OtherPRACTIONER ID NUMBER MHN