Theresa Mervenne, LCSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12066 Issued in FL

Practice address

735 Arlington Ave N
Suite 212
St Petersburg, FL 33701-3652

Phone

(206) 200-6059

NPI assigned

Jan 12, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1679939219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 34TH AVE N",
            "address_2": "#7844",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337348064",
            "telephone_number": "206-200-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 ARLINGTON AVE N",
            "address_2": "SUITE 212",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013652",
            "telephone_number": "206-200-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERVENNE",
        "first_name": "THERESA",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12066",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60173115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merriex Care Place LLC
• Carol Anne Merrill, ARNP
• Linda R Merrill, ED.S.
• Loryn R Merrill, DDS
• Deborah Merritt, ARNP
• Amy Merwarth, RD
• Arashi Elisa Mesa Melo
• Eneisy Mesa Morales
• Robert Mesaros
• Hector Felix Mesidor, M,D.

• Clinical Social Worker in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.