Provider Demographics
NPI:1376817460
Name:MYERS, HEATHER M (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:HEWETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:699 MORELAND AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1852
Mailing Address - Country:US
Mailing Address - Phone:404-208-3923
Mailing Address - Fax:
Practice Address - Street 1:6488 SPRING ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1895
Practice Address - Country:US
Practice Address - Phone:770-949-1595
Practice Address - Fax:770-489-7521
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional