Provider Demographics
NPI:1053445676
Name:MERCHANT, JEANETTE MARIE (MFT)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:MARIE
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MUNSEL CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-9279
Mailing Address - Country:US
Mailing Address - Phone:209-985-1920
Mailing Address - Fax:
Practice Address - Street 1:235 MUNSEL CREEK LOOP
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9279
Practice Address - Country:US
Practice Address - Phone:209-985-1920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1882101YM0800X
CAMFC36010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health