Provider Demographics
NPI:1477868248
Name:HILL-GLENN, DOLORES (LCSW)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:HILL-GLENN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1236
Mailing Address - Country:US
Mailing Address - Phone:610-644-6464
Mailing Address - Fax:610-644-4066
Practice Address - Street 1:3 RIVERSIDE DR
Practice Address - Street 2:UNIT #3
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-1840
Practice Address - Country:US
Practice Address - Phone:610-644-6464
Practice Address - Fax:610-792-3684
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW016152101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)