Active NPI
Liesal Marie Miller, MFT
- Marriage & Family Therapist
- Wylie, TX
National Provider Identifier
1285778852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 49391
- Practice address
- 205 S Ballard Ave
Wylie, TX 75098-3640 - Phone
- (469) 757-4525
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 202138 | TX | |
| Marriage & Family Therapist | 106H00000X | 49391 | CA | Primary |
Addresses
Primary practice location
205 S Ballard Ave
Wylie, TX 75098-3640
Mailing address
205 S Ballard Ave
Wylie, TX 75098-3640
Phone (469) 757-4525
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49391 | Other | CA | CALIFORNIA BOARD OF BEHAVIORAL SCIENCES |
| 202138 | Other | TX | TEXAS STATE BOARD OF EXAMINERS OF MARRIAGE AND FAMILY THERAPISTS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Liesal.Miller@BeaconCounselor.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 49391 | CA | MD | Marriage & Family Therapist |
| 202138 | TX | MD | Marriage & Family Therapist |
Interoperability endpoints
- liesal.miller@beaconcounselor.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589932800000",
"number": "1285778852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 S BALLARD AVE",
"city": "WYLIE",
"state": "TX",
"postal_code": "750983640",
"telephone_number": "469-757-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S BALLARD AVE",
"city": "WYLIE",
"state": "TX",
"postal_code": "750983640",
"telephone_number": "469-757-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "LIESAL",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "202138",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "49391",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
"identifier": "49391",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF EXAMINERS OF MARRIAGE AND FAMILY THERAPISTS",
"identifier": "202138",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Liesal.Miller@BeaconCounselor.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "205 S Ballard Ave",
"city": "Wylie",
"state": "TX",
"country_code": "US",
"postal_code": "750983640",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Wylie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.