Provider Demographics
NPI:1679149447
Name:HILL, GRACE E (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:E
Last Name:HILL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ERIN
Other - Last Name:TIBBETTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2885 W BATTLEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-3952
Mailing Address - Country:US
Mailing Address - Phone:417-761-5000
Mailing Address - Fax:
Practice Address - Street 1:3401 BERRYWOOD DR STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6515
Practice Address - Country:US
Practice Address - Phone:573-777-8455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230326401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical