DR. MARKUS MILLER PROVENCE (PHD) – Counseling Psychologist, NPI 1952920100

DR. MARKUS MILLER PROVENCE (PHD) is a healthcare provider. based in Austin, Texas. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 37537 (TX). The NPI Number for DR. MARKUS MILLER PROVENCE (PHD) is 1952920100

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARKUS MILLER PROVENCE (PHD)
NPI
1952920100
Phone
(650) 248-7274
Address
2600 W STASSNEY LN
Enumeration Date
8 April 2020
Last Update Date
2 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5129566463
Graduation Year
2016 (10 years ago)
PAC ID
4587100714
Group Practice PAC ID
2264886936
Professional Enrollment ID
I20240724003003
Address ID
TX787453401AU2600XLNXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

1,347 CLINICAL PSYCHOLOGIST in TX

Provider Addresses for DR. MARKUS MILLER PROVENCE (PHD)

  • 2600 W STASSNEY LN

    AUSTIN, TX 787453401

    Phone: (650) 248-7274

    Type: Location

  • 136 FLATLAND TRL

    SAN MARCOS, TX 786663296

    Phone: (650) 248-7274

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240724003003IClinical PsychologistTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78745)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264886936View full group profile
NameSpecialtyState
Mental Health CounselorTX
Clinical PsychologistTX
Clinical Social WorkerMI
Mental Health CounselorTX
Mental Health CounselorTX
Clinical PsychologistTX
Mental Health CounselorTX
Mental Health CounselorTX
Clinical Social WorkerTX
Marriage And Family TherapistTX

Reviews

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Frequently asked questions

What is the standard ID for DR. MARKUS MILLER PROVENCE (PHD) in the U.S.?
In the U.S., DR. MARKUS MILLER PROVENCE (PHD) is identified by NPI 1952920100.
Should I treat DR. MARKUS MILLER PROVENCE (PHD) as an active provider?
Patients and plans typically see DR. MARKUS MILLER PROVENCE (PHD) as active in the national extract.
Which specialty label fits DR. MARKUS MILLER PROVENCE (PHD)?
NPPES ties DR. MARKUS MILLER PROVENCE (PHD) to Counseling Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. MARKUS MILLER PROVENCE (PHD)?
DR. MARKUS MILLER PROVENCE (PHD) shows a connection to Austin, Texas in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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