MEDICARE: DR. OWEN ARTHUR BILLER ED.D. FICPP

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	101YP2500X	Professional Counselor	LPC0000000175	TN
2	103TC0700X	Clinical Psychologist	P0000000463	TN
3	106H00000X	Marriage & Family Therapist	LMT0000000082	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	621094229	OTHER	TN	TRI CARE
2	621094229	OTHER	TN	CIGNA
3	0015972	OTHER	TN	BLUE SHIELD BLUE CROSS
4	621094229	OTHER	TN	MAGELLAN
5	4287728	OTHER	TN	AETNA

General Provider Information

NPI Number	:	1689730384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OWEN ARTHUR BILLER ED.D. FICPP

Provider Business Mailing Address
First Line	:	PO BOX 2965
Second Line	:	SUITE C
City	:	CLEVELAND
State	:	TN
Zip	:	37320-2965
Country	:	US
Telephone Number	:	423-479-5672
Fax Number	:	423-479-5679

Provider Business Practice Location Address
First Line	:	2292 CHAMBLISS AVE NW
Second Line	:	SUITE C-2
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3862
Country	:	US
Telephone Number	:	423-479-5672
Fax Number	:	423-479-5679

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	01/04/2010

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Directions to “ DR. OWEN ARTHUR BILLER ED.D. FICPP” Practice Location

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