Provider Demographics
NPI:1578559662
Name:MEYER, ERIC C (PHD, LPC, CAC III)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:MEYER
Suffix:
Gender:M
Credentials:PHD, LPC, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4779 W 117TH WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7844
Mailing Address - Country:US
Mailing Address - Phone:720-272-8584
Mailing Address - Fax:866-215-4405
Practice Address - Street 1:1006 DEPOT HILL RD
Practice Address - Street 2:SUITE H3
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-6721
Practice Address - Country:US
Practice Address - Phone:720-272-8584
Practice Address - Fax:866-215-4405
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3043101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36931764Medicaid