Active NPI
Donna G Merritt, M. ED
- Mental Health Counselor
- Fulton, MO
National Provider Identifier
1669653408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2006028305
- Practice address
- 2625 Fairway Dr
Suite E
Fulton, MO 65251-3936 - Phone
- (573) 636-6727
- Fax
- (573) 761-5819
- NPI assigned
- Nov 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2006028305 | MO | Primary |
Addresses
Primary practice location
2625 Fairway Dr
Suite E
Fulton, MO 65251-3936
Mailing address
2625 Fairway Dr
Suite E
Fulton, MO 65251-3936
Phone (573) 636-6727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006028305 | MO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195516800000",
"number": "1669653408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 FAIRWAY DR",
"address_2": "SUITE E",
"city": "FULTON",
"state": "MO",
"postal_code": "652513936",
"telephone_number": "573-636-6727",
"fax_number": "573-761-5819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 FAIRWAY DR",
"address_2": "SUITE E",
"city": "FULTON",
"state": "MO",
"postal_code": "652513936",
"telephone_number": "573-636-6727",
"fax_number": "573-761-5819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "DONNA",
"middle_name": "G",
"credential": "M. ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-20",
"last_updated": "2007-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MO",
"license": "2006028305",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.