Provider Demographics
NPI:1033583158
Name:MEYERS, FELICIA (PHD)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 WESLEY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:IN
Mailing Address - Zip Code:47060-9635
Mailing Address - Country:US
Mailing Address - Phone:606-269-1475
Mailing Address - Fax:
Practice Address - Street 1:2111 SPENCER CT
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-6742
Practice Address - Country:US
Practice Address - Phone:502-262-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
KY174267103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor