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Individual

ELIZABETH MERRITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, QMHP-R, CADCIII

Contact information

Practice address
230 N 3RD ST STE 105, HARRISBURG, OR 97446-9679
(541) 952-1719
(541) 684-4162
Mailing address
230 N 3RD ST STE 105, HARRISBURG, OR 97446-9679
(541) 952-1719
(541) 684-4162

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500699658
OR
Enumeration date
03/03/2014
Last updated
09/15/2022
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