Healthcare Provider Details

I. General information

NPI: 1891356192
Provider Name (Legal Business Name): ELAINE MILLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S LAKELINE BLVD STE 103
CEDAR PARK TX
78613-2719
US

IV. Provider business mailing address

11705 SWEETWATER TRL
AUSTIN TX
78750-1335
US

V. Phone/Fax

Practice location:
  • Phone: 512-690-0515
  • Fax:
Mailing address:
  • Phone: 512-690-0515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number74562
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: