Marlisa Van Hout PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MARLISA VAN HOUT PC

Practice address

1907 S 17TH St
Suite 1
Wilmington, NC 28401-6679

Phone

(910) 343-8424

Fax

(910) 343-6989

NPI assigned

Mar 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marlisa Nance Van Hout, LPA

Title

President

Phone

(910) 343-8424

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1124298997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 S 17TH ST",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016679",
            "telephone_number": "910-343-8424",
            "fax_number": "910-343-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 S 17TH ST",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016679",
            "telephone_number": "910-343-8424",
            "fax_number": "910-343-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLISA VAN HOUT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "VAN HOUT",
        "authorized_official_first_name": "MARLISA",
        "authorized_official_middle_name": "NANCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-343-8424",
        "authorized_official_credential": "LPA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.