Provider Demographics
NPI:1174930234
Name:MERRILL, HEATHER L (LCMHC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:L
Last Name:MERRILL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:113 CROSBY ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4370
Mailing Address - Country:US
Mailing Address - Phone:603-516-9300
Mailing Address - Fax:603-740-9179
Practice Address - Street 1:25 OLD DOVER ROAD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3490
Practice Address - Country:US
Practice Address - Phone:603-516-9300
Practice Address - Fax:603-335-9278
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH101YM0800X
NH1190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health