Provider Demographics
NPI:1144591769
Name:PHILIP A HOUSE, PSY D, PC
Entity Type:Organization
Organization Name:PHILIP A HOUSE, PSY D, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:406-245-4446
Mailing Address - Street 1:PO BOX 22098
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-2098
Mailing Address - Country:US
Mailing Address - Phone:406-245-4446
Mailing Address - Fax:
Practice Address - Street 1:1629 AVENUE D
Practice Address - Street 2:BLDG B, STE 2
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3042
Practice Address - Country:US
Practice Address - Phone:406-245-4446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT270103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty