Lice Lounge Duluth, LLC

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

LICE LOUNGE DULUTH, LLC

Doing business as

Lice Lounge Duluth

Practice address

113 N 2ND Ave W
Duluth, MN 55802-1911

Phone

(218) 382-5423

NPI assigned

Nov 10, 2017

Organization subpart

No

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

Authorized official

Name

Kelly Rhea Merriman

Title

Owner, Coo

Phone

(651) 815-3644

Specialties & licenses 1

Addresses

Other names 1

• Lice Lounge Duluth Doing business as

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

{
    "created_epoch": "1510272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1376056481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 GASTON AVE",
            "city": "WHITE BEAR TOWNSHIP",
            "state": "MN",
            "postal_code": "551102338",
            "telephone_number": "651-815-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N 2ND AVE W",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021911",
            "telephone_number": "218-382-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICE LOUNGE DULUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-10",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "MERRIMAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RHEA",
        "authorized_official_title_or_position": "OWNER, COO",
        "authorized_official_telephone_number": "651-815-3644"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lice Lounge Duluth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey D. Lewis, MD
• Rebecca Lynn Lewis, PA-C
• Megan Renee Lexen, LICSW
• Christopher R. Lian, CRNA
• Dan Liao, MD
• Fayja Lichtenberg
• Monica Liddle, ND, LM, CPM
• Gerald Lieberg, SLP
• Dalerie Jean Lieberz, PT
• Life Counseling Duluth

• State or Local Public Health Clinic/Center in Duluth, MN
• Providers in Duluth, MN by specialty
• State or Local Public Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.