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General NPI Number Information
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NPI Number | 1124006895
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Entity Type | Individual
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Provider Name | JACQUELINE ADELINE MEYERS PSY.D, LP, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 2955 BIDDLE AVE STE 200
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City | WYANDOTTE
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State | MI
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Zip | 48192-5231
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Country | US
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Telephone | 734-991-3234
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Fax | 734-324-1566
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Provider Business Mailing Address
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Address Line | 3247 BIDDLE AVE APT 2
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City | WYANDOTTE
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State | MI
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Zip | 48192-5951
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Country | US
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Telephone | 734-991-3234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401008214
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301015288
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License Number State | MI
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