Provider Demographics
NPI:1578140760
Name:MYNHIER, JEFF GENE (MSW, LCAS, LCSW)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:GENE
Last Name:MYNHIER
Suffix:
Gender:M
Credentials:MSW, LCAS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 WILLOW DR STE 2
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7077
Mailing Address - Country:US
Mailing Address - Phone:919-968-2552
Mailing Address - Fax:
Practice Address - Street 1:891 WILLOW DR STE 2
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7077
Practice Address - Country:US
Practice Address - Phone:919-968-2552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0126441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical