Hobert Stanley Miller, LMSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

61928 Issued in TX

Practice address

15360 FM 850
Tyler, TX 75707-3916

Phone

(936) 645-9939

Fax

(903) 253-0466

NPI assigned

Jan 28, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sacred Holistic Path Sanctuary Refuge Incorporated

  • Community/Behavioral Health Agency
  • Tyler, TX
  • NPI 1235792599
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1073077673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9636",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757112636",
            "telephone_number": "936-645-9939",
            "fax_number": "903-253-0466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15360 FM 850",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757073916",
            "telephone_number": "936-645-9939",
            "fax_number": "903-253-0466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "HOBERT",
        "middle_name": "STANLEY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE PROFIT ORGANIZATION",
            "identifier": "82-5234611",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Miller, MS,CCC-SLP
• Clinton Miller, DDS
• Crystal Miller
• Darell R Miller, CCP
• Dorian Denise Miller, LVN
• Jan Miller
• Jessica Miller
• Kourtny Marie Miller, COTA
• Lisa Joyce Miller, COTA
• Madison Miller, MA, LPC-ASSOCIATE

• Professional Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.