Organization Active NPI

Merge Mental Health, LLC

  • Clinical Social Worker
  • Sarasota, FL
National Provider Identifier
1699362368
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MERGE MENTAL HEALTH, LLC
Practice address
1808 Orchid St
Sarasota, FL 34239-5131
Phone
(941) 500-3398
NPI assigned
Dec 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Dora Lee Damico, LCSWNPI 1609471903
Title
Manager
Phone
(941) 500-3398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1808 Orchid St
Sarasota, FL 34239-5131

Mailing address

15 Paradise PLZ # 337
Sarasota, FL 34239-6905
Phone (941) 500-3398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210125000661 FL Part B Supplier - Clinic/Group Practice 3779997267 Receives reassigned benefits from 1 practitioner
Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1699362368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARADISE PLZ # 337",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342396905",
            "telephone_number": "941-500-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 ORCHID ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395131",
            "telephone_number": "941-500-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERGE MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "DAMICO",
        "authorized_official_first_name": "DORA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-500-3398",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.