Provider Demographics
NPI:1982018321
Name:HOUCHIN, CHAD (PSYD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:HOUCHIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 VINCENT ST
Mailing Address - Street 2:ATTN: 21 OMRS/SGOW - MENTAL HEALTH
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-8581
Mailing Address - Fax:877-813-1756
Practice Address - Street 1:559 VINCENT ST
Practice Address - Street 2:ATTN: 21 OMRS/SGOW - MENTAL HEALTH
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-8581
Practice Address - Fax:877-813-1756
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005011103TC0700X
VA810005011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical