Active NPI
Denise Merrill, LMSW-CC
- Mental Health Counselor
- Gorham, ME
National Provider Identifier
1972253383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC21060
- Practice address
- 28 State St Ste 5
Gorham, ME 04038-1147 - Phone
- (207) 329-1213
- NPI assigned
- Mar 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC21060 | ME | Primary |
Addresses
Primary practice location
28 State St Ste 5
Gorham, ME 04038-1147
Mailing address
28 State St Ste 5
Gorham, ME 04038-1147
Phone (207) 329-1213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC21060 | ME | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1972253383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 STATE ST STE 5",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381147",
"telephone_number": "207-329-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 STATE ST STE 5",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381147",
"telephone_number": "207-329-1213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "DENISE",
"credential": "LMSW-CC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-28",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "MC21060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gorham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.