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General NPI Number Information
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NPI Number | 1003187162
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Entity Type | Organization
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Legal Business Name | RR MYERS CONSULTING, LLC
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Dates
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Enumeration Date | 01/21/2012
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Last Update Date | 01/21/2012
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Provider Practice Location Address
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Address Line | 6106 EDMONDSON AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-1830
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Country | US
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Telephone | 301-502-1181
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 HENRYTON RD
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104-1431
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Country | US
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Telephone | 301-502-1181
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Fax |
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Authorized Official
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Title or Position | THERAPIST/CONSULTANT
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Name | RANDALL R MYERS
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Credential | LCSW-C, PH.D.
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Telephone | 301-502-1181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 08588
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License Number State | MD
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