Provider Demographics
NPI:1932709318
Name:MILLER, LINDA MARIE (LPC, LCDC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 MANSIONS DR UNIT K3
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3711
Mailing Address - Country:US
Mailing Address - Phone:361-960-2624
Mailing Address - Fax:
Practice Address - Street 1:7202 MANSIONS DR UNIT K3
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3711
Practice Address - Country:US
Practice Address - Phone:136-196-0262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77765101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional