Individual
CASSANDRA MERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
20 E TABB ST STE 205, PETERSBURG, VA 23803-4560
(804) 536-5066
(202) 545-3413
Mailing address
20 E TABB ST STE 205, PETERSBURG, VA 23803-4560
(804) 536-5066
(202) 545-3413
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
VA
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701011674
LPC LICENSE NUMBER
VA
01
—
1912646142
PRIVATE INSURANCE
VA
05
—
1912646142
—
VA
Enumeration date
06/04/2022
Last updated
12/10/2024
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