Provider Demographics
NPI:1003016379
Name:MILLER, DAVID A (LPC, MED)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:LPC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WEST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2072
Mailing Address - Country:US
Mailing Address - Phone:512-608-2024
Mailing Address - Fax:
Practice Address - Street 1:1001 WEST AVE STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2072
Practice Address - Country:US
Practice Address - Phone:512-608-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14670101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health