| Doctor Name: | MATTHEW R MYERS |
| NPI Number: | 1669735478 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LSCSW |
| License Number: | 1197 |
| Business Practice Address: | 210 W 21st St Concordia, KS - 669015200 |
| Business Phone Number: | 7852438910 |
| Business Fax Number: | 7852431124 |
| Mailing Address: | Po Box 747, MANHATTAN |
| State: | KS |
| Postal Code: | 665050747 |
| Phone Number: | 7852438910 |
| Fax Number: | 7852431124 |
| NPI Enumeration Date: | 06/18/2012 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1197 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |