Active NPI
Daneen A Milam, PH.D.
- Psychologist
- San Antonio, TX
National Provider Identifier
1558304543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 22661
- Practice address
- 147 West Sunset Road
Suite 101
San Antonio, TX 78209 - Phone
- (210) 824-3391
- Fax
- (210) 828-2873
- NPI assigned
- Jun 14, 2006
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 2-2661 | TX | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 2-2661 | TX | |
| Adult Development & Aging Psychologist | 103TA0700X | 2-2661 | TX | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 2-2661 | TX | |
| Forensic Psychologist | 103TF0200X | 2-2661 | TX | |
| Psychologist | 103T00000X | 22661 | TX | Primary |
Addresses
Primary practice location
147 West Sunset Road
Suite 101
San Antonio, TX 78209
Mailing address
147 West Sunset Road
Suite 101
San Antonio, TX 78209
Phone (210) 824-3391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033612501 | 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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2-2661 | TX | MD | Addiction (Substance Use Disorder) Psychologist |
| 22661 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rosemary J. Stauber, PHD | Past | 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 and National Provider Directory roles.
-
- Clinical Psychologist
- San Antonio, TX
- NPI 1164698841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1558304543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 WEST SUNSET ROAD",
"address_2": "SUITE 101",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78209",
"telephone_number": "210-824-3391",
"fax_number": "210-828-2873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 WEST SUNSET ROAD",
"address_2": "SUITE 101",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78209",
"telephone_number": "210-824-3391",
"fax_number": "210-828-2873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILAM",
"first_name": "DANEEN",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "2-2661",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "2-2661",
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "TX",
"license": "2-2661",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "TX",
"license": "2-2661",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "TX",
"license": "2-2661",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "22661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "033612501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.