MEDICARE: GREG MILLER LMFT, CADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	C8529504	CA
2	106H00000X	Marriage & Family Therapist	201052	TX

General Provider Information

NPI Number	:	1790810869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREG MILLER LMFT, CADC

Provider Business Mailing Address
First Line	:	8913 SENDERA MESA DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-3680
Country	:	US
Telephone Number	:	512-590-9868
Fax Number	:

Provider Business Practice Location Address
First Line	:	5524 BEE CAVE RD STE I1
Second Line	:	SUITE I-1
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5246
Country	:	US
Telephone Number	:	512-590-9868
Fax Number	:

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

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	08/21/2012

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