Provider Demographics
NPI:1326768128
Name:MILLER, SARA MICHELLE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MICHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 AVENUE F
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3114
Mailing Address - Country:US
Mailing Address - Phone:913-375-5770
Mailing Address - Fax:
Practice Address - Street 1:4009 BANISTER LN STE 330
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8182
Practice Address - Country:US
Practice Address - Phone:512-668-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82228101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health