Provider Demographics
NPI:1588232359
Name:MYERS, DONALD ALVIN III (LPC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ALVIN
Last Name:MYERS
Suffix:III
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5328 REDBUD PL
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3253
Mailing Address - Country:US
Mailing Address - Phone:918-896-2099
Mailing Address - Fax:
Practice Address - Street 1:5328 REDBUD PL
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3253
Practice Address - Country:US
Practice Address - Phone:918-896-2099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional