Healthcare Provider Details

I. General information

NPI: 1669266813
Provider Name (Legal Business Name): SARA MILLER, LPC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 BIENVILLE BLVD STE M2
OCEAN SPRINGS MS
39564-3027
US

IV. Provider business mailing address

3820 CHAUMONT CIR
OCEAN SPRINGS MS
39564-8539
US

V. Phone/Fax

Practice location:
  • Phone: 228-215-0825
  • Fax:
Mailing address:
  • Phone: 606-923-8106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA MILLER
Title or Position: OWNER/LPC
Credential:
Phone: 606-923-8106