Provider Demographics
NPI:1073703120
Name:MYERS, GINGER (LMFT)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:MYERS
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:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:PINETOP
Mailing Address - State:AZ
Mailing Address - Zip Code:85935-0232
Mailing Address - Country:US
Mailing Address - Phone:928-297-7460
Mailing Address - Fax:
Practice Address - Street 1:141 N 6TH ST
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-5004
Practice Address - Country:US
Practice Address - Phone:928-532-2680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5171106H00000X
106H00000X
AZ10258106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist