Provider Demographics
NPI:1295822278
Name:MYERS, ANNE M (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
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 1:5721 MARLIN RD
Mailing Address - Street 2:STE 3100
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5644
Mailing Address - Country:US
Mailing Address - Phone:423-499-9986
Mailing Address - Fax:423-499-9986
Practice Address - Street 1:5721 MARLIN RD
Practice Address - Street 2:STE 3100
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5644
Practice Address - Country:US
Practice Address - Phone:423-499-9986
Practice Address - Fax:423-499-9986
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW45201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4143230OtherBCBS TN
TN4143230OtherBCBS TN