Provider Demographics
NPI:1861556482
Name:BILLER, BENJAMIN JAMES (MS SPE)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:JAMES
Last Name:BILLER
Suffix:
Gender:M
Credentials:MS SPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2965
Mailing Address - Street 2:
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:2006-12-20
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000011766103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical