Basic Information
| Provider Information | |||||||||
| NPI: | 1295150761 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ELIZABETH MEYERS, LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2535 E MOUNT HOPE AVE | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489101913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5178626554 | ||||||||
| FaxNumber: | 5173722542 | ||||||||
| Practice Location | |||||||||
| Address1: | 2535 E MOUNT HOPE AVE | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489101913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5178626554 | ||||||||
| FaxNumber: | 5173722542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2014 | ||||||||
| LastUpdateDate: | 02/20/2014 | ||||||||
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| AuthorizedOfficialLastName: | MEYERS | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 5178626554 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LMSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 6801016764 | MI | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | M15087 | 01 | MI | MEDICARE PTAN | OTHER | 121751 | 01 | MI | VALUE OPTIONS | OTHER | 200000024992 | 01 | MI | PHYSICIANS HEALTH PLAN OF MID MICHIGAN | OTHER | 0899596 | 01 | MI | BLUE CROSS/BLUE SHIELD | OTHER |