Provider Demographics
NPI:1497842751
Name:HILL, CHARLES KEITH (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:KEITH
Last Name:HILL
Suffix:
Gender:M
Credentials:MS, LMFT
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 1172
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-5172
Mailing Address - Country:US
Mailing Address - Phone:717-709-1010
Mailing Address - Fax:
Practice Address - Street 1:550 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-3442
Practice Address - Country:US
Practice Address - Phone:717-709-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000147106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist