Provider Demographics
NPI:1174198329
Name:MYERS, CHARLENE LEONA (LPC)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:LEONA
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEART AND SOUL COUNSELING AND CONSULTING SERVICES
Mailing Address - Street 2:250 COMMONS DR. #322. SMB 7453
Mailing Address - City:DUBOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-3808
Mailing Address - Country:US
Mailing Address - Phone:814-806-5264
Mailing Address - Fax:
Practice Address - Street 1:250 COMMONS DR # 322
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3808
Practice Address - Country:US
Practice Address - Phone:814-806-5264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional