Provider Demographics
NPI:1568513034
Name:ANXIETY AND STRESS CENTER, P.C.
Entity Type:Organization
Organization Name:ANXIETY AND STRESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:OUIDA
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:708-349-5433
Mailing Address - Street 1:18161 MORRIS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2108
Mailing Address - Country:US
Mailing Address - Phone:708-349-5433
Mailing Address - Fax:708-349-5434
Practice Address - Street 1:18161 MORRIS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2108
Practice Address - Country:US
Practice Address - Phone:708-349-5433
Practice Address - Fax:708-349-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071004128103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCH6894OtherRAILROAD PTAN
IL924301Medicare PIN