Provider Demographics
NPI:1013393347
Name:MILLER, STEPHANIE LOVELADY (LMSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LOVELADY
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:RENEE
Other - Last Name:LOVELADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:408 MULBERRY
Mailing Address - Street 2:P O BOX 250
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804
Mailing Address - Country:US
Mailing Address - Phone:325-646-9574
Mailing Address - Fax:325-646-7590
Practice Address - Street 1:408 MULBERRY
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76804
Practice Address - Country:US
Practice Address - Phone:325-646-9574
Practice Address - Fax:325-646-7590
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX607021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical