Provider Demographics
NPI:1144871401
Name:MERKL, ELIZABETH ANNE (MSW, CSWA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:MERKL
Suffix:
Gender:F
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 SW MADISON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4725
Mailing Address - Country:US
Mailing Address - Phone:541-818-0009
Mailing Address - Fax:541-780-6967
Practice Address - Street 1:260 SW MADISON AVE STE 105
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4725
Practice Address - Country:US
Practice Address - Phone:541-818-0009
Practice Address - Fax:541-780-6967
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA14430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health