Provider Demographics
NPI:1871384404
Name:MERDOC, EMILY BENJAMIN (MED, LGPC, NBCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BENJAMIN
Last Name:MERDOC
Suffix:
Gender:F
Credentials:MED, LGPC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7624 TALBOT RUN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-8402
Mailing Address - Country:US
Mailing Address - Phone:443-472-0372
Mailing Address - Fax:
Practice Address - Street 1:3528 URBANA PIKE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7742
Practice Address - Country:US
Practice Address - Phone:443-212-8775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional