MEDICARE: SUSAN CLEMENTS HOUCHINS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	24955	TX
2	103TC1900X	Counseling Psychologist	24955	TX

General Provider Information

NPI Number	:	1215079744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN CLEMENTS HOUCHINS PH.D.

Provider Business Mailing Address
First Line	:	608A W OLTORF ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5320
Country	:	US
Telephone Number	:	512-326-1105
Fax Number	:	512-326-5800

Provider Business Practice Location Address
First Line	:	608A W OLTORF ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-5320
Country	:	US
Telephone Number	:	512-326-1105
Fax Number	:	512-326-5800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	09/11/2025

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