Provider Demographics
NPI:1679186100
Name:HILL, ROBERT (LAPC, MA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:LAPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 JOHNS CREEK CT STE 260
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1226
Mailing Address - Country:US
Mailing Address - Phone:770-753-0350
Mailing Address - Fax:
Practice Address - Street 1:3905 JOHNS CREEK CT STE 260
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1226
Practice Address - Country:US
Practice Address - Phone:770-753-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1518917624OtherDR JEFFREY STULL