Healthcare Provider Details

I. General information

NPI: 1871764704
Provider Name (Legal Business Name): MARITESS A MYERS LPC, LMFT, LCDC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 06/26/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MEDIAL CENTER ROAD BLDG 36065 CARL R. DARNALL ARMY COMMUNITY HOSPITAL
FORT HOOD TX
76544
US

IV. Provider business mailing address

590 MEDIAL CENTER ROAD BLDG 36065 CARL R. DARNALL ARMY COMMUNITY HOSPITAL
FORT CAVAZOS TX
76544
US

V. Phone/Fax

Practice location:
  • Phone: 542-553-6640
  • Fax:
Mailing address:
  • Phone: 254-553-6640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number871
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number146
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number9858
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: