Provider Demographics
NPI:1861278178
Name:C D MERCHUT-KRUGER, LCSW, PLLC
Entity type:Organization
Organization Name:C D MERCHUT-KRUGER, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MERCHUT-KRUGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-302-5176
Mailing Address - Street 1:3306 FOREST HILL AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3434
Mailing Address - Country:US
Mailing Address - Phone:847-302-5176
Mailing Address - Fax:
Practice Address - Street 1:9562 KINGS CHARTER DR STE 102
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-8065
Practice Address - Country:US
Practice Address - Phone:804-503-5346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty