Provider Demographics
NPI:1972725968
Name:MILLSAP, JIM L (LPC)
Entity type:Individual
Prefix:
First Name:JIM
Middle Name:L
Last Name:MILLSAP
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 COUNTY ROAD 33640
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-0642
Mailing Address - Country:US
Mailing Address - Phone:903-491-3606
Mailing Address - Fax:903-784-2253
Practice Address - Street 1:203 COUNTY ROAD 33640
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-0642
Practice Address - Country:US
Practice Address - Phone:903-491-3606
Practice Address - Fax:903-784-2253
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11736101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor