Provider Demographics
NPI:1679726822
Name:MILLIKEN, BRIAN (LMFT, LPCC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MILLIKEN
Suffix:
Gender:M
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 S SAINT FRANCIS DR STE 1D
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7004
Mailing Address - Country:US
Mailing Address - Phone:505-301-3408
Mailing Address - Fax:866-593-5859
Practice Address - Street 1:2074 GALISTEO ST STE B4
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2157
Practice Address - Country:US
Practice Address - Phone:505-301-3408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-01
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0157981106H00000X
NM0157201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist