Provider Demographics
NPI:1437810363
Name:MILLER, JESSICA MCCREARY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MCCREARY
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 WHITETAIL DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2064
Mailing Address - Country:US
Mailing Address - Phone:903-452-7001
Mailing Address - Fax:
Practice Address - Street 1:708 WHITETAIL DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2064
Practice Address - Country:US
Practice Address - Phone:903-452-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional