Provider Demographics
NPI:1497037246
Name:MYERS, MICHAEL R (MSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:MYERS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 HOSBROOK RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2901
Mailing Address - Country:US
Mailing Address - Phone:513-426-3290
Mailing Address - Fax:513-672-0053
Practice Address - Street 1:8040 HOSBROOK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2901
Practice Address - Country:US
Practice Address - Phone:513-426-3290
Practice Address - Fax:513-672-0053
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1000212.SUPV.1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical