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NPI Code Detail

MEDICARE: DESHERA MYERS

MEDICARE: DESHERA MYERS
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1851250112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESHERA MYERS
Provider Business Mailing Address
First Line : 2022 EVERGREEN TERRACE DR E APT 2
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-3918
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 S WALL ST
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-3240
Country : US
Telephone Number : 618-252-9036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “ DESHERA MYERS ” Practice Location

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