Carole Lynn Merritt Doherty, LMSW

Individual provider Active NPI Clinical Social Worker · Kalkaska, MI

NPI 1487793147 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487793147
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801057167 (MI)
Practice address
509 N Birch St
Kalkaska, MI 49646-8414
Phone
(231) 258-5133
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Community Mental Health Past
since Feb 1, 2007
Accepting new patients
District Health Department No 10 Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801057167 MI Yes

Addresses

Primary practice location

509 N Birch St
Kalkaska, MI 49646-8414

Mailing address

5128 Meadowlark LN
Williamsburg, MI 49690-8622
Phone (231) 624-0091

Other providers in Kalkaska, MI

All providers in Kalkaska, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.