Provider Demographics
NPI:1346013364
Name:MCMILLEN, ASHTON (LMFT, LPC-A)
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:MCMILLEN
Suffix:
Gender:F
Credentials:LMFT, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 POSITANO LOOP
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77808-5439
Mailing Address - Country:US
Mailing Address - Phone:830-480-2626
Mailing Address - Fax:
Practice Address - Street 1:THE MADE WELL HOUSE
Practice Address - Street 2:107 S PRESTON AVE.
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803
Practice Address - Country:US
Practice Address - Phone:979-428-4663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87754101YP2500X
TX203443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional