Provider Demographics
NPI:1255879078
Name:MEYERS, EMILY ELIZABETH (LPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:MEYERS
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 1:200 CHAPEL CRK
Mailing Address - Street 2:APT #308
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-2585
Mailing Address - Country:US
Mailing Address - Phone:920-309-0541
Mailing Address - Fax:
Practice Address - Street 1:21516 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:ABITA SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70420-3906
Practice Address - Country:US
Practice Address - Phone:920-309-0541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1245754894OtherLONGBRANCH RECOVERY
LA1578091104OtherLONGBRANCH WELLNESS