Provider Demographics
NPI:1568444669
Name:HOUCK, GEORGE FREDERICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:FREDERICK
Last Name:HOUCK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24500 CENTER RIDGE RD
Mailing Address - Street 2:#125
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5601
Mailing Address - Country:US
Mailing Address - Phone:440-871-8102
Mailing Address - Fax:440-871-8102
Practice Address - Street 1:24500 CENTER RIDGE RD
Practice Address - Street 2:#125
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5601
Practice Address - Country:US
Practice Address - Phone:440-871-8102
Practice Address - Fax:440-871-8102
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4815103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical