Provider Demographics
NPI:1124546924
Name:HILL, JAMES ROSS (MMFT, LMFT, CAC-P)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROSS
Last Name:HILL
Suffix:
Gender:M
Credentials:MMFT, LMFT, CAC-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 RIVER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PACOLET
Mailing Address - State:SC
Mailing Address - Zip Code:29372-3906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:187 W BROAD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3234
Practice Address - Country:US
Practice Address - Phone:864-582-7588
Practice Address - Fax:864-562-4117
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
SC7005106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAD10SPMedicaid