Provider Demographics
NPI:1588022248
Name:HILL, ANDREW (LCSW, CBIS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:LCSW, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 NORTH 5TH STREET WEST
Mailing Address - Street 2:SUITE F, #211
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2953
Mailing Address - Country:US
Mailing Address - Phone:406-215-2225
Mailing Address - Fax:406-215-2226
Practice Address - Street 1:425 NORTH 5TH STREET WEST
Practice Address - Street 2:SUITE F, #211
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2953
Practice Address - Country:US
Practice Address - Phone:406-215-2225
Practice Address - Fax:406-215-2226
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-09
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-162481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical