Provider Demographics
NPI:1174493266
Name:NICOLE MYERS, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Entity type:Organization
Organization Name:NICOLE MYERS, LICENSED MARRIAGE AND FAMILY THERAPIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:714-305-0266
Mailing Address - Street 1:17712 CALGARY AVE
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3939
Mailing Address - Country:US
Mailing Address - Phone:714-305-0266
Mailing Address - Fax:206-326-1066
Practice Address - Street 1:4811 EUREKA AVE STE G1
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3368
Practice Address - Country:US
Practice Address - Phone:714-305-0266
Practice Address - Fax:206-326-1066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-05
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty