Provider Demographics
NPI:1003150780
Name:HILL, MATTHEW PAUL (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PAUL
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 MEMORIAL HWY STE E3
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4576
Mailing Address - Country:US
Mailing Address - Phone:570-351-3193
Mailing Address - Fax:
Practice Address - Street 1:6107 MEMORIAL HWY STE E3
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4576
Practice Address - Country:US
Practice Address - Phone:570-351-3193
Practice Address - Fax:813-200-1253
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15545101YM0800X, 101YM0800X
NC9782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional