Provider Demographics
NPI:1174673149
Name:MCMILLAN, SARA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:J
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5522
Mailing Address - Country:US
Mailing Address - Phone:512-391-0200
Mailing Address - Fax:
Practice Address - Street 1:3660 STONE RIDGE RD
Practice Address - Street 2:BLDG A-101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7759
Practice Address - Country:US
Practice Address - Phone:512-391-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX057481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical