Provider Demographics
NPI:1275857906
Name:MYERS, HATTIE BETH (CSW PHD)
Entity Type:Individual
Prefix:DR
First Name:HATTIE
Middle Name:BETH
Last Name:MYERS
Suffix:
Gender:F
Credentials:CSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 W END AVE
Mailing Address - Street 2:5F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3535
Mailing Address - Country:US
Mailing Address - Phone:212-866-6294
Mailing Address - Fax:
Practice Address - Street 1:915 W END AVE
Practice Address - Street 2:5F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3535
Practice Address - Country:US
Practice Address - Phone:212-866-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR028711-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst