Individual provider Active NPI

Wanda D Miller, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Dallas, TX
National Provider Identifier
1265388813
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
10112 Issued in TX
Practice address
4701 Samuell Blvd
Dallas, TX 75228-6828
Phone
(972) 861-5611
NPI assigned
Mar 6, 2026
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 10112 TX Primary

Addresses

Primary practice location

4701 Samuell Blvd
Dallas, TX 75228-6828

Mailing address

612 Jones St
Euless, TX 76040-5127

Other practice location 1

612 Jones St
Euless, TX 76040-5127
Phone (214) 743-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10112TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Mental Health & Mental Retardation Center PastSince Jul 30, 2014 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1772755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1265388813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 JONES ST",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760405127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SAMUELL BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752286828",
            "telephone_number": "972-861-5611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "612 Jones St",
            "address_purpose": "LOCATION",
            "city": "Euless",
            "state": "TX",
            "postal_code": "760405127",
            "country_code": "US",
            "telephone_number": "214-743-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "WANDA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-06",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "10112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.