Provider Demographics
NPI:1861139198
Name:MILLER, FARYN (LPC)
Entity type:Individual
Prefix:
First Name:FARYN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16500 SAN PEDRO AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2253
Mailing Address - Country:US
Mailing Address - Phone:210-725-5570
Mailing Address - Fax:
Practice Address - Street 1:16500 SAN PEDRO AVE STE 215
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2253
Practice Address - Country:US
Practice Address - Phone:210-725-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86743101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor