Provider Demographics
NPI:1144702309
Name:SEEGRIST, MERRI LYNNE (LCSW)
Entity type:Individual
Prefix:
First Name:MERRI
Middle Name:LYNNE
Last Name:SEEGRIST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49280 HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411-8225
Mailing Address - Country:US
Mailing Address - Phone:435-256-1965
Mailing Address - Fax:
Practice Address - Street 1:49280 HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:BANDON
Practice Address - State:OR
Practice Address - Zip Code:97411-8225
Practice Address - Country:US
Practice Address - Phone:435-256-1965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT171M00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator