MEDICARE: MYERS LIFE COACHING LLC

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
1	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1346871050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYERS LIFE COACHING LLC

Provider Business Mailing Address
First Line	:	3650 S POINTE CIR STE 113
Second Line	:
City	:	LAUGHLIN
State	:	NV
Zip	:	89029-0422
Country	:	US
Telephone Number	:	702-803-9392
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 S POINTE CIR STE 113
Second Line	:
City	:	LAUGHLIN
State	:	NV
Zip	:	89029-0422
Country	:	US
Telephone Number	:	702-803-9392
Fax Number	:	877-289-3606

Authorized Official
Title or Position	:	CEO
Name	:	JASMINE SAROYA MYERS
Credential	:	PSYD
Telephone Number	:	702-803-9392

Provider Enumeration Date	:	01/31/2020
Last Update Date	:	08/16/2021

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Directions to “MYERS LIFE COACHING LLC ” Practice Location

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