Healthcare Provider Details

I. General information

NPI: 1558706390
Provider Name (Legal Business Name): TAMMY MYERS LMHC, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 KENDALL WAY STE 230
MALTA NY
12020-4399
US

IV. Provider business mailing address

7 KENDALL WAY STE 230
BALLSTON SPA NY
12020-4399
US

V. Phone/Fax

Practice location:
  • Phone: 518-309-2299
  • Fax: 518-309-3153
Mailing address:
  • Phone: 518-309-2299
  • Fax: 518-309-3153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number28466
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number006043
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: