Provider Demographics
NPI:1689730384
Name:BILLER, OWEN ARTHUR (EDD FICPP)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:ARTHUR
Last Name:BILLER
Suffix:
Gender:M
Credentials:EDD FICPP
Other - Prefix:DR
Other - First Name:(OWEN) TOM
Other - Middle Name:ARTHUR
Other - Last Name:BILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDD FICPP
Mailing Address - Street 1:PO BOX 2965
Mailing Address - Street 2:SUITE C
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-2965
Mailing Address - Country:US
Mailing Address - Phone:423-479-5672
Mailing Address - Fax:423-479-5679
Practice Address - Street 1:2292 CHAMBLISS AVE NW
Practice Address - Street 2:SUITE C-2
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3862
Practice Address - Country:US
Practice Address - Phone:423-479-5672
Practice Address - Fax:423-479-5679
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000175101YP2500X
TNP0000000463103TC0700X
TNLMT0000000082106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN621094229OtherTRI CARE
TN621094229OtherCIGNA
TN0015972OtherBLUE SHIELD BLUE CROSS
TN621094229OtherMAGELLAN
TN4287728OtherAETNA
TN3683736Medicare UPIN