Provider Demographics
NPI:1417210865
Name:MAYER, DEVYN DEONA (LPC)
Entity Type:Individual
Prefix:
First Name:DEVYN
Middle Name:DEONA
Last Name:MAYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DEVYN
Other - Middle Name:DEONA
Other - Last Name:MERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3520 RANCH HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-7659
Mailing Address - Country:US
Mailing Address - Phone:817-709-3243
Mailing Address - Fax:817-441-6129
Practice Address - Street 1:104 W RUSSELL ST
Practice Address - Street 2:PYRAMID COUNSELING CENTER
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5360
Practice Address - Country:US
Practice Address - Phone:817-594-8780
Practice Address - Fax:817-862-7478
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38692OtherAETNA BETTER HEALTH
TX398481OtherAVAILITY
TX300568801Medicaid
TX712LLCOtherBLUE CROSS BLUE SHIELD OF TEXAS