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General NPI Number Information
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NPI Number | 1487195582
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Entity Type | Organization
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Legal Business Name | MIDWESTERN PSYCHOLOGICAL CONSULTANTS
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 6201 W MAIN ST STE 130
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City | MARYVILLE
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State | IL
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Zip | 62062-6870
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Country | US
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Telephone | 618-979-5087
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Fax | 618-551-2802
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Provider Business Mailing Address
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Address Line | 6201 W MAIN ST STE 130
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City | MARYVILLE
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State | IL
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Zip | 62062-6870
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Country | US
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Telephone | 618-979-5087
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Fax | 618-551-2802
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBIN LEE MYERS
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Credential | PSY.D., ABPP
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Telephone | 618-979-5087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071006112
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License Number State | IL
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