Provider Demographics
NPI:1508557737
Name:MYERS, JOSEPH RAY (LMHCA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RAY
Last Name:MYERS
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 E 106TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1703
Mailing Address - Country:US
Mailing Address - Phone:317-270-8380
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 165
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3056
Practice Address - Country:US
Practice Address - Phone:317-572-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001969A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health