Merrifield, David

Merrifield, David is an individual health care provider with primary practice located at 121 W Main St Suite 350, Port Washington WI 53074-1813. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Merrifield, David can be contacted via phone (262) 284-8130.

Contact Information

Primary practice address
121 W Main St Suite 350 Port Washington WI 53074-1813
Fax: (262) 284-8104
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 106123 Wisconsin

Profile Details

NPI number 1437140829
LBN Legal business name Merrifield, David
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437140829 NPPES
Wisconsin MEDICAID 39578000

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