MEDICARE: AUSTIN MEYERS

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932878873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN MEYERS

Provider Business Mailing Address
First Line	:	205 SE JACKSON ST
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-3341
Country	:	US
Telephone Number	:	541-464-6406
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 SE JACKSON ST
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-3341
Country	:	US
Telephone Number	:	541-464-6406
Fax Number	:

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

Provider Enumeration Date	:	09/13/2021
Last Update Date	:	09/13/2021

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Directions to “ AUSTIN MEYERS ” Practice Location

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