MEDICARE: MS. MELINDA Y MYERS LMHC

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	101YM0800X	Mental Health Counselor	P96926	NY
2	101YM0800X	Mental Health Counselor	008251	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	008251-1	OTHER	NY	LICENSED MENTAL HEALTH COUNSELOR

General Provider Information

NPI Number	:	1316298821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELINDA Y MYERS LMHC

Provider Business Mailing Address
First Line	:	PO BOX 219
Second Line	:
City	:	WYNANTSKILL
State	:	NY
Zip	:	12198-0219
Country	:	US
Telephone Number	:	518-283-6500
Fax Number	:	518-283-7156

Provider Business Practice Location Address
First Line	:	614 COOPER HILL RD
Second Line	:
City	:	WYNANTSKILL
State	:	NY
Zip	:	12198-2906
Country	:	US
Telephone Number	:	518-283-6500
Fax Number	:	518-283-7156

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

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	01/24/2023

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