Provider Demographics
NPI:1255110037
Name:MYERS, MARIA (LMHCA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 MEADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CLE ELUM
Mailing Address - State:WA
Mailing Address - Zip Code:98922-5812
Mailing Address - Country:US
Mailing Address - Phone:206-963-3459
Mailing Address - Fax:
Practice Address - Street 1:421 MEADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-5812
Practice Address - Country:US
Practice Address - Phone:206-963-3459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60773910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health