Healthcare Provider Details

I. General information

NPI: 1316098569
Provider Name (Legal Business Name): JEANNE A FIELD MILLER MS, LPC, LMFT, LCDC,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEANNE A FIELD MS, LPC, LMFT, LCDC,

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 06/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4091 SUMMERHILL SQ
TEXARKANA TX
75503-2768
US

IV. Provider business mailing address

4091 SUMMERHILL SQ
TEXARKANA TX
75503-2768
US

V. Phone/Fax

Practice location:
  • Phone: 903-792-8887
  • Fax: 903-792-8799
Mailing address:
  • Phone: 903-792-8887
  • Fax: 903-792-8799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4172
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11296
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP408022
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number003299-030394
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: