Provider Demographics
NPI:1528551918
Name:MEYERS, BRADFORD THOMAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:THOMAS
Last Name:MEYERS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5178 DAVID LN
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:45710-8085
Mailing Address - Country:US
Mailing Address - Phone:773-828-9017
Mailing Address - Fax:
Practice Address - Street 1:8 N COURT ST STE 409
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2450
Practice Address - Country:US
Practice Address - Phone:740-520-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07715103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist