MEDICARE: SANDRA DAWN MYERS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	7121	LA

General Provider Information

NPI Number	:	1295232007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA DAWN MYERS LCSW

Provider Business Mailing Address
First Line	:	400 W CAPITOL AVE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-3436
Country	:	US
Telephone Number	:	323-676-1233
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W CAPITOL AVE
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-3436
Country	:	US
Telephone Number	:	323-676-1233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2018
Last Update Date	:	12/15/2025

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