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Individual

CHESTER G. MERRILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.A.S.A.C

Contact information

Practice address
7 SEAFIELD LN, WESTHAMPTON BEACH, NY 11978-2714
(631) 288-1122
Mailing address
1031 WEST ST, RIVERHEAD, NY 11901-2925

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24505
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24505
C.A.S.A.C
Enumeration date
02/07/2014
Last updated
02/07/2014
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