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General NPI Number Information
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NPI Number | 1134016793
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Entity Type | Individual
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Provider Name | CALEB JOSHUA MYERS LPC
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Gender | Male
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1650 COUNTY SERVICES PKWY SW
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City | MARIETTA
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State | GA
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Zip | 30008-4010
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Country | US
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Telephone | 800-729-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 494 FAITH ST NW
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City | MARIETTA
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State | GA
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Zip | 30064-2144
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Country | US
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Telephone | 423-987-7322
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC015809
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License Number State | GA
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