Provider Demographics
NPI:1174894463
Name:MERRITE WILLIAMS, NENA M (LMFT)
Entity type:Individual
Prefix:
First Name:NENA
Middle Name:M
Last Name:MERRITE WILLIAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 88
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39043-0088
Mailing Address - Country:US
Mailing Address - Phone:601-824-0342
Mailing Address - Fax:601-824-0349
Practice Address - Street 1:613 MARQUETTE ROAD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-0088
Practice Address - Country:US
Practice Address - Phone:601-824-0342
Practice Address - Fax:601-824-0349
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist