Provider Demographics
NPI:1811148273
Name:JOHN C. HOUSE, PHD
Entity type:Organization
Organization Name:JOHN C. HOUSE, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERSIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:865-567-5648
Mailing Address - Street 1:135 FOX RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3349
Mailing Address - Country:US
Mailing Address - Phone:865-567-5648
Mailing Address - Fax:865-531-3948
Practice Address - Street 1:135 FOX RD
Practice Address - Street 2:SUITE E
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3349
Practice Address - Country:US
Practice Address - Phone:865-567-5648
Practice Address - Fax:865-531-3948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1522103TP2701X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3729403Medicare PIN