Provider Demographics
NPI:1649581299
Name:HILL, CHAD WILLIAM (MA, LPC)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:WILLIAM
Last Name:HILL
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E SUNSHINE ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2641
Mailing Address - Country:US
Mailing Address - Phone:417-501-8812
Mailing Address - Fax:417-501-8813
Practice Address - Street 1:300 E SUNSHINE ST
Practice Address - Street 2:SUITE I
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2641
Practice Address - Country:US
Practice Address - Phone:417-501-8812
Practice Address - Fax:417-501-8813
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010003028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional