Active NPI
Tracy G Myers, PH.D.
- Clinical Psychologist
- Fort Lauderdale, FL
National Provider Identifier
1871078956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY9011
- Practice address
- 325 SW 28TH St
Fort Lauderdale, FL 33315-2612 - Phone
- (954) 357-4898
- NPI assigned
- Sep 25, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MCAP100418 | FL | |
| Clinical Psychologist | 103TC0700X | PY9011 | FL | Primary |
Addresses
Primary practice location
325 SW 28TH St
Fort Lauderdale, FL 33315-2612
Mailing address
325 SW 28TH St
Fort Lauderdale, FL 33315-2612
Phone (954) 357-4810
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MCAP100418 | FL | MD | Addiction (Substance Use Disorder) Counselor |
| PY9011 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537833600000",
"number": "1871078956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 SW 28TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333152612",
"telephone_number": "954-357-4810",
"fax_number": "954-357-4898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 SW 28TH ST",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333152612",
"telephone_number": "954-357-4898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "TRACY",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-25",
"last_updated": "2018-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "FL",
"license": "MCAP100418",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY9011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.