Provider Demographics
NPI:1639548431
Name:HILL, KELLI BLUE (LPC-S)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:BLUE
Last Name:HILL
Suffix:
Gender:F
Credentials:LPC-S
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 563
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-0563
Mailing Address - Country:US
Mailing Address - Phone:225-754-2501
Mailing Address - Fax:
Practice Address - Street 1:8369 FLORIDA BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7862
Practice Address - Country:US
Practice Address - Phone:225-754-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional