Provider Demographics
NPI:1023132149
Name:MYERS, RHONDA KARYL (LPC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KARYL
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 MORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-3773
Mailing Address - Country:US
Mailing Address - Phone:573-761-0444
Mailing Address - Fax:
Practice Address - Street 1:400 E HIGH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-3215
Practice Address - Country:US
Practice Address - Phone:573-761-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006026084101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1649269622OtherBILLING NPI
MO431008405OtherFCCMO TAX ID
MO844753414OtherTAX IDENTIFICATION NUMBER
MO1467597872OtherJEFF CITY NPI
MO506201904OtherHCY MEDICAID NUMBER