MEDICARE: CHANEL MYERS LMFT

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	106H00000X	Marriage & Family Therapist	1803	CT

General Provider Information

NPI Number	:	1871943621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANEL MYERS LMFT

Provider Business Mailing Address
First Line	:	292 ELMWOOD CIR
Second Line	:
City	:	CHESHIRE
State	:	CT
Zip	:	06410-4211
Country	:	US
Telephone Number	:	203-494-7544
Fax Number	:	203-745-4426

Provider Business Practice Location Address
First Line	:	292 ELMWOOD CIR
Second Line	:
City	:	CHESHIRE
State	:	CT
Zip	:	06410-4211
Country	:	US
Telephone Number	:	203-494-7544
Fax Number	:	203-745-4426

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

Provider Enumeration Date	:	06/13/2016
Last Update Date	:	03/03/2026

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