Provider Demographics
NPI:1487851804
Name:MYERS, HELEN HOLLAND (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:HOLLAND
Last Name:MYERS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:770 MARNE HWY
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3073
Mailing Address - Country:US
Mailing Address - Phone:856-234-0843
Mailing Address - Fax:856-234-0843
Practice Address - Street 1:770 MARNE HWY
Practice Address - Street 2:SUITE 2D
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3073
Practice Address - Country:US
Practice Address - Phone:856-234-0843
Practice Address - Fax:856-234-0843
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046067001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ598155000OtherMAGELLAN PROVIDER NUMBER
166802Medicare UPIN