Provider Demographics
NPI:1679885925
Name:MYERS, BEVERLY JEAN (MA, PHD, AHNP-C)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JEAN
Last Name:MYERS
Suffix:
Gender:F
Credentials:MA, PHD, AHNP-C
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:JEAN
Other - Last Name:HULSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NCC, ALC
Mailing Address - Street 1:2909 HIGHLAND AVE S
Mailing Address - Street 2:SHERATON APARTMENTS # 501
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1932
Mailing Address - Country:US
Mailing Address - Phone:205-903-1482
Mailing Address - Fax:
Practice Address - Street 1:2909 HIGHLAND AVE S
Practice Address - Street 2:SHERATON APARTMENTS # 501
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1932
Practice Address - Country:US
Practice Address - Phone:205-903-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2019-06-26
Deactivation Date:2018-06-27
Deactivation Code:
Reactivation Date:2019-06-19
Provider Licenses
StateLicense IDTaxonomies
AL3088101YM0800X, 101YA0400X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty