Provider Demographics
NPI:1245482488
Name:MERRITT, ALYCIA (MS)
Entity type:Individual
Prefix:
First Name:ALYCIA
Middle Name:
Last Name:MERRITT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 CONGRESS ST STE 1205-23
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7309
Mailing Address - Country:US
Mailing Address - Phone:570-350-0613
Mailing Address - Fax:978-219-9443
Practice Address - Street 1:27 CONGRESS ST STE 1205-23
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-7309
Practice Address - Country:US
Practice Address - Phone:570-350-0613
Practice Address - Fax:978-219-9443
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA8723101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health