Provider Demographics
NPI:1083621734
Name:MYERS, JANICE E (PHD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:E
Last Name:MYERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:A
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:7501 NW EASTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-1798
Mailing Address - Country:US
Mailing Address - Phone:816-305-8592
Mailing Address - Fax:
Practice Address - Street 1:7501 NW EASTSIDE DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152-1798
Practice Address - Country:US
Practice Address - Phone:816-305-8592
Practice Address - Fax:816-741-0900
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0194103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO15093022OtherBCBS
MO0005215Medicare PIN