Healthcare Provider Details

I. General information

NPI: 1689730384
Provider Name (Legal Business Name): OWEN ARTHUR BILLER ED.D. FICPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: (OWEN) TOM ARTHUR BILLER ED.D. FICPP

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2292 CHAMBLISS AVE NW SUITE C-2
CLEVELAND TN
37311-3862
US

IV. Provider business mailing address

PO BOX 2965 SUITE C
CLEVELAND TN
37320-2965
US

V. Phone/Fax

Practice location:
  • Phone: 423-479-5672
  • Fax: 423-479-5679
Mailing address:
  • Phone: 423-479-5672
  • Fax: 423-479-5679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0000000175
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP0000000463
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMT0000000082
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: