Provider Demographics
NPI:1245297159
Name:MEYERS, OREN I (PHD)
Entity type:Individual
Prefix:DR
First Name:OREN
Middle Name:I
Last Name:MEYERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3659 GREEN RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5727
Mailing Address - Country:US
Mailing Address - Phone:216-896-0111
Mailing Address - Fax:
Practice Address - Street 1:3659 GREEN RD
Practice Address - Street 2:SUITE 222
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5727
Practice Address - Country:US
Practice Address - Phone:216-896-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6126103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP31351Medicare ID - Type Unspecified