Provider Demographics
NPI:1316098569
Name:FIELD MILLER, JEANNE A (MS, LPC, LMFT, LCDC,)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:A
Last Name:FIELD MILLER
Suffix:
Gender:F
Credentials:MS, LPC, LMFT, LCDC,
Other - Prefix:MS
Other - First Name:JEANNE
Other - Middle Name:A
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC, LMFT, LCDC,
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4172101YA0400X
TX11296101YP2500X
ARP408022101YP2500X
TX003299-030394106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR98096OtherBCBS OF AR
TX62-08018OtherUNITED BEHAVIORAL HEALTH
TX095309302Medicaid
TX126784OtherCOMPSYCH
TX201640OtherVALUE OPTIONS
TX7887121OtherAETNA
TX80816LOtherBCBS OF TX