Provider Demographics
NPI:1093959124
Name:HILL, KIMBERLY REGINA (LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:REGINA
Last Name:HILL
Suffix:
Gender:F
Credentials:LPC
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 78292
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30357-2292
Mailing Address - Country:US
Mailing Address - Phone:404-914-2788
Mailing Address - Fax:404-393-9780
Practice Address - Street 1:920 DANNON VW SW STE 3204
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2161
Practice Address - Country:US
Practice Address - Phone:404-914-2788
Practice Address - Fax:404-393-9780
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional