Provider Demographics
NPI:1629279534
Name:JEANNE A. FIELD MILLER DOING BUSINESS AS SUMMERHILL COUNSELING CENTER
Entity Type:Organization
Organization Name:JEANNE A. FIELD MILLER DOING BUSINESS AS SUMMERHILL COUNSELING CENTER
Other - Org Name:SUMMERHILL COUNSELING CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIELD MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LMFT, LCDC
Authorized Official - Phone:903-792-8887
Mailing Address - Street 1:4091 SUMMERHILL SQ
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2768
Mailing Address - Country:US
Mailing Address - Phone:903-792-8887
Mailing Address - Fax:903-792-8799
Practice Address - Street 1:4091 SUMMERHILL SQ
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2768
Practice Address - Country:US
Practice Address - Phone:903-792-8887
Practice Address - Fax:903-792-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4172101YA0400X
TX11296101YP2500X
ARP08022101YP2500X
TX0032990-030394106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201640OtherVALUE OPTIONS
TX119588OtherSUPERIOR HEALTH INSURANCE
AR98096OtherBLUE CROSS BLUE SHIELD
TX80816LOtherBLUE CROSS BLUE SHIELD