Provider Demographics
NPI:1831162809
Name:MYERS, CARL SHELDON (LSCSW)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:SHELDON
Last Name:MYERS
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3649 SW BURLINGAME RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2051
Mailing Address - Country:US
Mailing Address - Phone:785-266-6751
Mailing Address - Fax:785-266-4533
Practice Address - Street 1:3649 SW BURLINGAME RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2051
Practice Address - Country:US
Practice Address - Phone:785-266-6751
Practice Address - Fax:785-266-4533
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS555104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS069400OtherBLUE CROSS/BLUE SHIELD
KS011092Medicare ID - Type Unspecified