Mr Myron Russell Proctor, CADC, LMSW is a
Social Worker based in La Fayette, Georgia. Mr Myron Russell Proctor is licensed to practice in Georgia (license number MSW011227) and his current practice location is
201 N Main St, La Fayette, Georgia. He can be reached at his office (for appointments etc.) via phone at
(678) 590-5589.
NPI number for Mr Myron Russell Proctor is 1245875962 and his current mailing address is 121 Lazy Oak Trl, Ringgold, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1245875962.
Healthcare Provider's Profile
| Full Name | Mr Myron Russell Proctor |
|---|
| Gender | Male |
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| Speciality | Social Worker |
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| Location | 201 N Main St, La Fayette, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245875962
- Provider Enumeration Date: 11/18/2019
- Last Update Date: 08/21/2023
Medical Identifiers
Medical identifiers for Mr Myron Russell Proctor such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245875962 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0527 (Georgia) | Secondary |
| 104100000X | Social Worker | MSW011227 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Myron Russell Proctor is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Myron Russell Proctor, CADC, LMSW
121 Lazy Oak Trl,
Ringgold, GA 30736-5573
Ph: (423) 785-7391 | Mr Myron Russell Proctor, CADC, LMSW
201 N Main St,
La Fayette, GA 30728-2419
Ph: (678) 590-5589 |
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