Carol Sybella Merriman, MS LP LICSW

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4740 Issued in MN

Practice address

1406 6TH Avenue North
St Cloud Hospital
St Cloud, MN 56303-1901

Phone

(320) 251-2700

Fax

(320) 656-7115

NPI assigned

May 12, 2006

Last updated

Jun 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1255381869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD HOSPITAL",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVENUE NORTH",
            "address_2": "ST CLOUD HOSPITAL",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563031901",
            "telephone_number": "320-251-2700",
            "fax_number": "320-656-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIMAN",
        "first_name": "CAROL",
        "middle_name": "SYBELLA",
        "credential": "MS LP LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12387",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711183500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Menth, MSN, RN, ARNP, CNP
• Niloufer Moiz Merchant, ED.D
• Albert Joseph Mercuri, MD
• Merls Transportation
• Genife Gera Merrell
• Heather J Merritt, RD
• Shawn Merritt, CCC-SLP
• John E Mertz, MD PHD
• Nathan Charles Messbarger
• Sarah Messer, RN BSN

• Clinical Psychologist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.