Provider Demographics
NPI:1790810869
Name:MILLER, GREG (LMFT, CADC)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMFT, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8913 SENDERA MESA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-3680
Mailing Address - Country:US
Mailing Address - Phone:512-590-9868
Mailing Address - Fax:
Practice Address - Street 1:5524 BEE CAVE RD STE I1
Practice Address - Street 2:SUITE I-1
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5246
Practice Address - Country:US
Practice Address - Phone:512-590-9868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC8529504101YA0400X
TX201052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)