Individual provider Active NPI

Jennifer Irene Myers, LMFT 97263; 01450 NV

  • Marriage & Family Therapist
  • Carson City, NV
National Provider Identifier
1558607382
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01450 Issued in NV
Practice address
2874 N Carson St Ste 215
Carson City, NV 89706-1682
Phone
(775) 885-7717
Fax
(775) 283-0231
NPI assigned
Dec 26, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 97263 CA
Marriage & Family Therapist 106H00000X 01450 NV Primary

Addresses

Primary practice location

2874 N Carson St Ste 215
Carson City, NV 89706-1682

Mailing address

PO Box 208
Carson City, NV 89702-0208
Phone (775) 885-7717

Other practice location 1

209 6th Street
Marysville, CA 95961
Phone (530) 741-6275

Other identifiers 1

IdentifierTypeStateIssuer
1558607382MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01450NVMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Counseling & Neurotherapy, LLC Marriage & Family Therapist Past Accepting new patients
Marvin Behavioral Health Ma PC Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1558607382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897020208",
            "telephone_number": "775-885-7717",
            "fax_number": "775-283-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2874 N CARSON ST STE 215",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897061682",
            "telephone_number": "775-885-7717",
            "fax_number": "775-283-0231"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 6th Street",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "CA",
            "postal_code": "95961",
            "country_code": "US",
            "telephone_number": "530-741-6275",
            "fax_number": "530-749-7913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JENNIFER",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "LMFT 97263; 01450 NV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "97263",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558607382",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.