Healthcare Provider Details

I. General information

NPI: 1568513034
Provider Name (Legal Business Name): ANXIETY AND STRESS CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2007
Last Update Date: 06/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18161 MORRIS AVE SUITE 102
HOMEWOOD IL
60430-2108
US

IV. Provider business mailing address

18161 MORRIS AVE SUITE 102
HOMEWOOD IL
60430-2108
US

V. Phone/Fax

Practice location:
  • Phone: 708-349-5433
  • Fax: 708-349-5434
Mailing address:
  • Phone: 708-349-5433
  • Fax: 708-349-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number071004128
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071004128
License Number StateIL

VIII. Authorized Official

Name: DR. HOLLY OUIDA HOUSTON
Title or Position: OWNER
Credential: PH.D.
Phone: 708-349-5433