Provider Demographics
NPI:1164564613
Name:MYERS, H MICHELE (LCSW)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:MICHELE
Last Name:MYERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 HARRISON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403
Mailing Address - Country:US
Mailing Address - Phone:801-510-4790
Mailing Address - Fax:801-621-2560
Practice Address - Street 1:4155 HARRISON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-510-4790
Practice Address - Fax:801-621-2560
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTSW12616135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical