Carmen R Merrill, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106339 Issued in TX

Practice address

407 Auburn Pines Dr
Montgomery, TX 77316-1955

Phone

(210) 374-4924

Fax

(210) 374-4924

NPI assigned

Apr 30, 2025

Last updated

Jul 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Icebreaker Therapy PLLC

  • Clinical Social Worker
  • Montgomery, TX
  • NPI 1174445506
  NPD (past) Authorized official

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1700674504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "210-374-4924",
            "fax_number": "210-374-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 AUBURN PINES DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773161955",
            "telephone_number": "210-374-4924",
            "fax_number": "210-374-4924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Balcones Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787314298",
            "country_code": "US",
            "telephone_number": "210-374-4924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "CARMEN",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-30",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "106339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia L. Melton, D.C.
• Memorial Hermann Surgery Center Woodforest LLC (Memorial Hermann Surgery Center Woodforest)
• Dana Mendoza
• Monica Ashley Mendoza, PT, DPT, MS
• Jaymes Mennel
• Micah Bosley MD, PLLC
• Micah Bosley MD, PLLC
• Micah Tomlinson MD PA (Montgomery Medical Center)
• Michael a. Kaplan, MD, PA (Lake Area Urgent Care)
• Rosemarie Middleton, DDS, MS

• Clinical Social Worker in Montgomery, TX
• Providers in Montgomery, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.