Provider Demographics
NPI:1831250083
Name:MYERS, BEVERLY JEAN (LMHP)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JEAN
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-6893
Mailing Address - Country:US
Mailing Address - Phone:402-371-3302
Mailing Address - Fax:402-371-3241
Practice Address - Street 1:910 HEATHER LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-6893
Practice Address - Country:US
Practice Address - Phone:402-371-3302
Practice Address - Fax:402-371-3241
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025361200Medicaid