Provider Demographics
NPI:1588652853
Name:MYERS, COLLIN A (PHD, LPCC-S)
Entity Type:Individual
Prefix:DR
First Name:COLLIN
Middle Name:A
Last Name:MYERS
Suffix:
Gender:M
Credentials:PHD, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 DARROW RD STE 1601
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2694
Mailing Address - Country:US
Mailing Address - Phone:330-940-2522
Mailing Address - Fax:
Practice Address - Street 1:4301 DARROW RD STE 1601
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2694
Practice Address - Country:US
Practice Address - Phone:330-940-2522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0000637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional