Provider Demographics
NPI:1154448918
Name:HILL-HERNANDEZ, MARCIA (LCPC, CADC)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:HILL-HERNANDEZ
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19525 N SAN PABLO ST
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-2041
Mailing Address - Country:US
Mailing Address - Phone:630-639-3358
Mailing Address - Fax:
Practice Address - Street 1:19395 N JOHN WAYNE PKWY
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-2833
Practice Address - Country:US
Practice Address - Phone:480-524-2699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
IL180.005422101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)