Provider Demographics
NPI:1316266083
Name:MYERS, EMILY JANE (MSED, LPC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JANE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MAPLEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:NEW MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44442-9416
Mailing Address - Country:US
Mailing Address - Phone:330-506-4193
Mailing Address - Fax:
Practice Address - Street 1:5208 MAHONING AVE
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1858
Practice Address - Country:US
Practice Address - Phone:330-797-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 0800360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health