Individual provider Active NPI

Daneen A Milam, PH.D.

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1558304543
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
22661 Issued in TX
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

Updated by the provider on May 22, 2012

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
033612501MedicaidTX

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

LicenseStateTypeSpecialty
2-2661TXMDAddiction (Substance Use Disorder) Psychologist
22661TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.