Healthcare Provider Details

I. General information

NPI: 1366827859
Provider Name (Legal Business Name): MALEIGHA R MYERS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2015
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 MILLRACE DR STE 202
EUGENE OR
97403-2536
US

IV. Provider business mailing address

2876 BAILEY LN
EUGENE OR
97401-6924
US

V. Phone/Fax

Practice location:
  • Phone: 541-940-8804
  • Fax:
Mailing address:
  • Phone: 651-280-0102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7676
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: