MEDICARE: DR. STEPHANIE BROOKE MILLER PH.D., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	75348	TX
2	101YP2500X	Professional Counselor	LPC-18358	AZ
3	103TF0200X	Forensic Psychologist	41017	TX

General Provider Information

NPI Number	:	1114402831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE BROOKE MILLER PH.D., LPC

Provider Business Mailing Address
First Line	:	4099 MCEWEN RD STE 574
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5367
Country	:	US
Telephone Number	:	432-355-8350
Fax Number	:

Provider Business Practice Location Address
First Line	:	4099 MCEWEN RD STE 574
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5367
Country	:	US
Telephone Number	:	432-355-8350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	12/08/2025

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