Provider Demographics
NPI:1710382270
Name:MYERS, ERICA RENAE (LPCC-S)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:RENAE
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 GWEN HVN
Mailing Address - Street 2:
Mailing Address - City:ARGILLITE
Mailing Address - State:KY
Mailing Address - Zip Code:41121-8937
Mailing Address - Country:US
Mailing Address - Phone:606-585-8531
Mailing Address - Fax:
Practice Address - Street 1:71 GWEN HVN
Practice Address - Street 2:
Practice Address - City:ARGILLITE
Practice Address - State:KY
Practice Address - Zip Code:41121-8937
Practice Address - Country:US
Practice Address - Phone:606-585-8531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
KYKY-1039101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional