Provider Demographics
NPI:1508318007
Name:CAROL F. MYERS, LPC, LLC
Entity Type:Organization
Organization Name:CAROL F. MYERS, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-640-7630
Mailing Address - Street 1:3283 ELECTRA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-1088
Mailing Address - Country:US
Mailing Address - Phone:719-640-7630
Mailing Address - Fax:719-373-1725
Practice Address - Street 1:2985 BROADMOOR VALLEY RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4484
Practice Address - Country:US
Practice Address - Phone:719-640-7630
Practice Address - Fax:719-373-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty