Provider Demographics
NPI:1609236470
Name:MEYERS, JANE LOUISE (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:LOUISE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 THE CIRCUIT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-2329
Mailing Address - Country:US
Mailing Address - Phone:607-242-9630
Mailing Address - Fax:
Practice Address - Street 1:1175 VESTAL AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1609
Practice Address - Country:US
Practice Address - Phone:607-444-5099
Practice Address - Fax:307-348-1730
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084-489101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health