Provider Demographics
NPI:1972766814
Name:MYERS, CRAIG THOMAS (LMHC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:THOMAS
Last Name:MYERS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9770 BAYMEADOWS ROAD
Mailing Address - Street 2:SUITE 139
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2912
Mailing Address - Country:US
Mailing Address - Phone:904-997-0096
Mailing Address - Fax:904-997-0092
Practice Address - Street 1:9770 OLD BAYMEADOWS RD
Practice Address - Street 2:SUITE 139
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7909
Practice Address - Country:US
Practice Address - Phone:904-997-0096
Practice Address - Fax:904-997-0092
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC 4673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health