MEDICARE: CHRISTINE K MYERS MA NCC LPC

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	101YP2500X	Professional Counselor	PC004659	PA
2	101YM0800X	Mental Health Counselor	2241	WV

General Provider Information

NPI Number	:	1407046865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE K MYERS MA NCC LPC

Provider Business Mailing Address
First Line	:	4735 WADESVILLE RD
Second Line	:
City	:	BELLEVILLE
State	:	WV
Zip	:	26133-8148
Country	:	US
Telephone Number	:	724-504-4718
Fax Number	:

Provider Business Practice Location Address
First Line	:	4735 WADESVILLE RD
Second Line	:
City	:	BELLEVILLE
State	:	WV
Zip	:	26133-8148
Country	:	US
Telephone Number	:	724-504-4718
Fax Number	:

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	01/01/2017

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