Provider Demographics
NPI:1336148915
Name:MILAM, CAROL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MILAM
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 EGRET BAY BLVD
Mailing Address - Street 2:STE 305
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3860
Mailing Address - Country:US
Mailing Address - Phone:281-333-5740
Mailing Address - Fax:281-333-4013
Practice Address - Street 1:18333 EGRET BAY BLVD
Practice Address - Street 2:STE 305
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3860
Practice Address - Country:US
Practice Address - Phone:281-333-5740
Practice Address - Fax:281-333-4013
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17429OtherLICENSE
TX71153OtherLICENSE