Provider Demographics
NPI:1093888695
Name:MYERS, FELICITY COSTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:FELICITY
Middle Name:COSTIN
Last Name:MYERS
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 1:1 WINDSOR CV
Mailing Address - Street 2:SUITE 108
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-1833
Mailing Address - Country:US
Mailing Address - Phone:803-699-8887
Mailing Address - Fax:803-699-8824
Practice Address - Street 1:1 WINDSOR CV
Practice Address - Street 2:SUITE 108
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1833
Practice Address - Country:US
Practice Address - Phone:803-699-8887
Practice Address - Fax:803-699-8824
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC517103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPS0365Medicaid