Active NPI
Kathryn Denise Miers, LPC
- Professional Counselor
- Montgomery, TX
National Provider Identifier
1336234996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19016
- Practice address
- 18445 Hwy 105 W
Ste 102 PMB 215
Montgomery, TX 77356 - Phone
- (936) 443-8092
- Fax
- (936) 342-9081
- NPI assigned
- Oct 3, 2006
- Last updated
- Nov 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 19016 | TX | Primary |
Addresses
Primary practice location
18445 Hwy 105 W
Ste 102 PMB 215
Montgomery, TX 77356
Mailing address
18445 Hwy 105 W
Ste 102 PMB 215
Montgomery, TX 77356
Phone (936) 443-8092
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 266499 | Medicaid | TX | |
| 84641L | Other | TX | BLUE CROSS BLUE SHIELD |
| 174737004 | Medicaid | TX | |
| 84846L | Other | TX | BLUE CROSS BLUE SHIELD |
| 174737003 | Medicaid | TX |
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 |
|---|---|---|---|
| 19016 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1336234996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18445 HWY 105 W",
"address_2": "STE 102 PMB 215",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "77356",
"telephone_number": "936-443-8092",
"fax_number": "936-342-9081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18445 HWY 105 W",
"address_2": "STE 102 PMB 215",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "77356",
"telephone_number": "936-443-8092",
"fax_number": "936-342-9081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIERS",
"first_name": "KATHRYN",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "266499",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "84641L",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "174737004",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "84846L",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "174737003",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.