Provider Demographics
NPI:1083910103
Name:MYERS, STEVEN J (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:MYERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1313
Mailing Address - Country:US
Mailing Address - Phone:201-477-8311
Mailing Address - Fax:
Practice Address - Street 1:297 KINDERKAMACK RD
Practice Address - Street 2:SUITE 212-214
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1538
Practice Address - Country:US
Practice Address - Phone:201-477-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00507200103T00000X, 103T00000X
NJ663282103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool