Provider Demographics
NPI:1265870976
Name:DR MICHAEL F MAYERS LICENSED PSYCHOLOGIST LLC
Entity type:Organization
Organization Name:DR MICHAEL F MAYERS LICENSED PSYCHOLOGIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FITZGERALD
Authorized Official - Last Name:MAYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-208-7340
Mailing Address - Street 1:719 OLDE HICKORY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4985
Mailing Address - Country:US
Mailing Address - Phone:717-208-7340
Mailing Address - Fax:717-208-7348
Practice Address - Street 1:719 OLDE HICKORY RD
Practice Address - Street 2:SUITE A
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4985
Practice Address - Country:US
Practice Address - Phone:717-208-7340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSO16011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty