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Deactivated NPI 1003899444 Deactivated / Inactive NPI Female Practitioner

Jan Evans Miller , LPC

Psychologist • Fort Worth, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jan Miller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 21, 2005
NPI Deactivation Date August 26, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Jan Miller, LPC was a registered Psychologist practicing in Fort Worth, TX. Throughout an active medical career spanning 17 years, Jan Miller provided care at the practice location at 3309 WINTHROP AVE until profile deactivation on 2022-08-26.

Practice Location & Contact Primary Location

Practice Address

3309 Winthrop Ave
Ste 100-A

Fort Worth, TX 761165614

Telephone 8179928129
Fax 8175854836
Associated Practice Facility / Clinic
🏢 B&w Enterprise Facility NPI 1720265523

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Fort Worth, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.7 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
75 Specialists

Practicing in Fort Worth, TX (2266 Statewide)

Telehealth Adoption Rate
4.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License TX 112266

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Edna Chism Nicholas

Social Worker - Clinical

NPI 1073933669
Paul Thompson , LPC (DMIN)

Counselor - Professional

NPI 1306836341

LPC(DMIN)

Dr. William Summy , PhD, LPC

Counselor - Professional

NPI 1780691139

Doctor of Philosophy (Ph.D.), Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 26, 2022

Record deactivated on August 26, 2022

NPI Profile Active August 29, 2012

NPI status registered as active in NPPES database

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Updated Practice Location August 29, 2012

Registered at 3309 WINTHROP AVE, STE 100-A, FORT WORTH, TX 761165614 (Tel: 8179928129)

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Updated Business Mailing Address August 29, 2012

Registered at 3309 WINTHROP AVE, STE 100-A, FORT WORTH, TX 761165614 (Tel: 8179928129)

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Provider Name / Credentials Updated August 29, 2012

Recorded as JAN MILLER, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2012

Psychologist (License #112266 in TX)

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Initial NPI Registration & Enumeration November 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003899444
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 21, 2005
Last Update: August 29, 2012
Deactivation Date: August 26, 2022

Mailing Address

3309 Winthrop Ave, Ste 100-A

Fort Worth, TX 761165614

Phone: 8179928129

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
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