Provider Demographics
NPI:1770037517
Name:MYERS, PAUL (LPC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:MYERS
Suffix:
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 1:4500 HILLCREST RD STE 115
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5403
Mailing Address - Country:US
Mailing Address - Phone:469-213-6400
Mailing Address - Fax:469-213-6473
Practice Address - Street 1:4500 HILLCREST RD STE 115
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5403
Practice Address - Country:US
Practice Address - Phone:469-213-6400
Practice Address - Fax:469-213-6473
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health