Callista Jo Merrill, LADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fairfield, ME
NPI 1932889698 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1932889698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LC6787 (ME)
- Practice address
- 343 Center Rd
Fairfield, ME 04937-3361 - Phone
- (207) 431-7388
- NPI assigned
- Jul 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC6787 | ME | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LC6787 | ME | Yes |
Addresses
Primary practice location
343 Center Rd
Fairfield, ME 04937-3361
Mailing address
343 Center Rd
Fairfield, ME 04937-3361
Phone (207) 431-7388
Other providers in Fairfield, ME
- Barbara Mansir
- Scott Mayo
- Christian McGowan
- Carly Anne McKeil
- Elizabeth Anne McMurray
- Jennifer Lynn Morgan
- Jo-Ann A Morin
- Michelle L Mosher
- Msad 49
- Mark Nawfel
All providers in Fairfield, ME · Addiction (Substance Use Disorder) Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.