Provider Demographics
NPI:1154891901
Name:MYERS, ALLYSE MICHEL (LPC)
Entity type:Individual
Prefix:MS
First Name:ALLYSE
Middle Name:MICHEL
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6667 CLOVERLAWN CIR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8726
Mailing Address - Country:US
Mailing Address - Phone:614-423-9340
Mailing Address - Fax:
Practice Address - Street 1:665 E DUBLIN GRANVILLE RD STE 290
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3245
Practice Address - Country:US
Practice Address - Phone:614-846-6265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OHC.2002430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor