Provider Demographics
NPI:1245574821
Name:MILLER, WARREN L JR (LICSW, LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:L
Last Name:MILLER
Suffix:JR
Gender:M
Credentials:LICSW, LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 SOUTHWEST FWY STE 635
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7112
Mailing Address - Country:US
Mailing Address - Phone:713-850-0049
Mailing Address - Fax:
Practice Address - Street 1:4635 SOUTHWEST FWY STE 635
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7112
Practice Address - Country:US
Practice Address - Phone:713-850-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA926431041C0700X
TX1048561041C0700X
DCLC500796181041C0700X
TX634781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty