Healthcare Provider Details

I. General information

NPI: 1720170327
Provider Name (Legal Business Name): JOHN RICHARD MYERS LCPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 8TH AVE SE
CUT BANK MT
59427-3318
US

IV. Provider business mailing address

PO BOX 2164
CUT BANK MT
59427-2164
US

V. Phone/Fax

Practice location:
  • Phone: 907-690-5200
  • Fax:
Mailing address:
  • Phone: 907-690-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-24340
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: