Provider Demographics
NPI:1144019076
Name:MYERS, MALIK RAKIM
Entity type:Individual
Prefix:
First Name:MALIK
Middle Name:RAKIM
Last Name:MYERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1804
Mailing Address - Country:US
Mailing Address - Phone:202-470-4185
Mailing Address - Fax:
Practice Address - Street 1:412 1ST ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1804
Practice Address - Country:US
Practice Address - Phone:202-470-4185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician