Provider Demographics
NPI:1538467766
Name:LAIRD-MYERS, CARRIE ANN (MS)
Entity Type:Individual
Prefix:MISS
First Name:CARRIE
Middle Name:ANN
Last Name:LAIRD-MYERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 PACIFIC BLVD SE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-7903
Mailing Address - Country:US
Mailing Address - Phone:541-321-2278
Mailing Address - Fax:541-246-8826
Practice Address - Street 1:2225 PACIFIC BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-7907
Practice Address - Country:US
Practice Address - Phone:541-321-2278
Practice Address - Fax:541-246-8826
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 104100000X
ORR4935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker