Myron, Elmer George

Myron, Elmer George is an sole proprietor health care provider with primary practice located at 4041 N. Central Ave Building C, Phoenix AZ 85012-3133. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Myron, Elmer George can be contacted via phone (602) 279-5262.

Contact Information

Primary practice address
4041 N. Central Ave Building C Phoenix AZ 85012-3133
Phone: (602) 279-5262
Fax: (602) 279-5393
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11597 Arizona
Behavioral Health & Social Service Providers / Social Worker 104100000X 4125 Arizona

Profile Details

NPI number 1710197843
LBN Legal business name Myron, Elmer George
Credentials LBSW, LISAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2007
Last updated Aug 29th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710197843 NPPES
Arizona MEDICAID 910209

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