=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447118799
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA MILLER M.A., LPC-ASSOCIATE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2026
-----------------------------------------------------
Last Update Date | 01/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 875 PORTER RD
-----------------------------------------------------
City | BARTONVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76226-8229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-240-3466
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5706 COLEMAN DR
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37312-2429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-580-8761
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 87722
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------