Provider Demographics
NPI:1205877271
Name:MYERS, AUDREY JEAN (MS LPC)
Entity type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:JEAN
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:
Other - Last Name:SHEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2209 FOREST HILLS DR
Mailing Address - Street 2:STE 19
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112
Mailing Address - Country:US
Mailing Address - Phone:717-540-4420
Mailing Address - Fax:717-540-4427
Practice Address - Street 1:2209 FOREST HILLS DR
Practice Address - Street 2:STE 19
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112
Practice Address - Country:US
Practice Address - Phone:717-540-4420
Practice Address - Fax:717-540-4427
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional