Provider Demographics
NPI:1871389510
Name:MYERS, JAYLE' (LMSW)
Entity type:Individual
Prefix:
First Name:JAYLE'
Middle Name:
Last Name:MYERS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1648
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-1648
Mailing Address - Country:US
Mailing Address - Phone:404-294-3836
Mailing Address - Fax:
Practice Address - Street 1:3110 CLIFTON SPRINGS RD STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4600
Practice Address - Country:US
Practice Address - Phone:404-244-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011061101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor