Individual provider Active NPI

Dennis L. Merritt, MA

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1851456842
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3147-123 Issued in WI
Practice address
1619 Monroe St
Madison, WI 53711-2063
Phone
(608) 255-9330
Fax
(608) 255-7810
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3147-123 WI Primary

Addresses

Primary practice location

1619 Monroe St
Madison, WI 53711-2063

Mailing address

1619 Monroe St
Madison, WI 53711-2063
Phone (608) 255-9330

Other identifiers 1

IdentifierTypeStateIssuer
39200700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240322002839 WI Practitioner - Clinical Social Worker 7618902164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Psychology Associates, Inc.Group PAC ID 9133114333, 8 clinicians

Practice addresses (Care Compare)

6110 N Port Washington Rd
Glendale, WI 53217-4308
Phone (414) 962-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3147-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis L Merritt LCSW PHD SC Clinical Current Accepting new patients
Integral Psychology Center PastSince Jan 21, 2009 Accepting new patients

Locations

6110 N Port Washington Rd
Glendale, WI 53217
Phone (414) 332-7400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851456842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 MONROE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112063",
            "telephone_number": "608-255-9330",
            "fax_number": "608-255-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "DENNIS",
        "middle_name": "L.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3147-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39200700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.