Provider Demographics
NPI:1891873220
Name:MYERS, BRUCE EDWARD (LMHP)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:EDWARD
Last Name:MYERS
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 E GOLD COAST RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-5799
Mailing Address - Country:US
Mailing Address - Phone:402-592-0639
Mailing Address - Fax:402-592-0014
Practice Address - Street 1:124 S 24TH ST
Practice Address - Street 2:SUITE 230
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1226
Practice Address - Country:US
Practice Address - Phone:402-978-5656
Practice Address - Fax:402-591-5075
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1429101YM0800X
NE7641041C0700X
NE5391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health