IndividualActive
John Miranda, LPC, LCDC
NPI 1104479930 · Addiction (Substance Use Disorder) Psychologist · San Antonio, TX
Provider details
- NPI number
- 1104479930
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) PsychologistBehavioral Health & Social Service Providers
- Credential
- LPC, LCDC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 115868 (TX)
Practice location
110 E Houston St
San Antonio, TX 78205-2990
Phone: (210) 414-4327
Fax: (210) 451-0492
Mailing address
5300 Encanta St Apt 402
San Antonio, TX 78233-6459
Registry dates
- Enumerated
- 2019-07-21
- Last updated
- 2021-04-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.