Provider Demographics
NPI:1376952135
Name:HILL, JANE (PHD, LPC, LMHC-S)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:PHD, LPC, LMHC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5056
Mailing Address - Country:US
Mailing Address - Phone:321-987-9047
Mailing Address - Fax:
Practice Address - Street 1:667 WALNUT DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5056
Practice Address - Country:US
Practice Address - Phone:321-987-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70539101YM0800X, 101YP2500X
FLMH16107101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health