Provider Demographics
NPI:1952757692
Name:EDWARDS-ORR, MERLE
Entity Type:Individual
Prefix:
First Name:MERLE
Middle Name:
Last Name:EDWARDS-ORR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MERLE
Other - Middle Name:
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:68 FERNCREST AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3511
Mailing Address - Country:US
Mailing Address - Phone:401-941-3249
Mailing Address - Fax:
Practice Address - Street 1:68 FERNCREST AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02905-3511
Practice Address - Country:US
Practice Address - Phone:401-941-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.00003361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical