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NPI Code Detail

MEDICARE: ANDRIA MCCREA MYERS BS

MEDICARE: ANDRIA MCCREA MYERS BS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1154964690
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRIA MCCREA MYERS BS
Provider Business Mailing Address
First Line : 9581 BEMBRIDGE MILL DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-2493
Country : US
Telephone Number : 904-508-5178
Fax Number :
Provider Business Practice Location Address
First Line : 841 PRUDENTIAL DR FL 12
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8874
Country : US
Telephone Number : 904-508-5178
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2019
Last Update Date : 10/28/2019

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