Healthcare Provider Details

I. General information

NPI: 1396180972
Provider Name (Legal Business Name): JEANNE A. FIELD MILLER D/B/A SUMMERHILL COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/09/2013
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 Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number4172
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberP408022
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number003299-030394
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number9571
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number11296
License Number StateTX

VIII. Authorized Official

Name: MS. JEANNE A. FIELD MILLER
Title or Position: OWNER
Credential: MS,LPC,LMFT,LCDC,NCC
Phone: 903-792-8887