Provider Demographics
NPI:1629435425
Name:HILL, DARLENE MICHELLE
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:MICHELLE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:MICHELLE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC, LMFTA, MHP
Mailing Address - Street 1:2602 S 38TH ST UNIT 63
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-6665
Mailing Address - Country:US
Mailing Address - Phone:253-226-1862
Mailing Address - Fax:
Practice Address - Street 1:2602 S 38TH ST UNIT 63
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-6665
Practice Address - Country:US
Practice Address - Phone:253-226-1862
Practice Address - Fax:888-859-4882
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X, 101YM0800X
WALP00050887164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1972735157Medicaid