Provider Demographics
NPI:1497106363
Name:HILL, DONNA (LPC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 W 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-2621
Mailing Address - Country:US
Mailing Address - Phone:985-807-5031
Mailing Address - Fax:
Practice Address - Street 1:600 MARINERS PLAZA DR
Practice Address - Street 2:SUITE 603
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-6822
Practice Address - Country:US
Practice Address - Phone:985-465-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2713101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA$$$$$$$$$Medicaid