Provider Demographics
NPI:1154488617
Name:HILLMAN, MARSHA (CSW)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:CSW
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 740513
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33474-0513
Mailing Address - Country:US
Mailing Address - Phone:561-716-4815
Mailing Address - Fax:561-638-7063
Practice Address - Street 1:13550 JOG RD
Practice Address - Street 2:SUITE 204
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3808
Practice Address - Country:US
Practice Address - Phone:561-716-4815
Practice Address - Fax:561-638-7063
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR-0246371041C0700X
FLISW 28931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32767OtherVALUE OPTIONS
FL0037078OtherAETNA