Provider Demographics
NPI:1326636648
Name:HILL, DEMAINE TERRENCE (LCSWA)
Entity Type:Individual
Prefix:
First Name:DEMAINE
Middle Name:TERRENCE
Last Name:HILL
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:MR
Other - First Name:DEMAINE
Other - Middle Name:TERRENCE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:85 MACKEYS RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-9609
Mailing Address - Country:US
Mailing Address - Phone:252-217-8583
Mailing Address - Fax:
Practice Address - Street 1:108 E KING ST
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1956
Practice Address - Country:US
Practice Address - Phone:252-217-8583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-03
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical