Provider Demographics
NPI:1710310917
Name:HILL, LAMAR TERRELL (LICSW)
Entity Type:Individual
Prefix:
First Name:LAMAR
Middle Name:TERRELL
Last Name:HILL
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 15TH AVE S STE 206
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1125
Mailing Address - Country:US
Mailing Address - Phone:218-227-5503
Mailing Address - Fax:218-227-5506
Practice Address - Street 1:4342 15TH AVE S STE 206
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1125
Practice Address - Country:US
Practice Address - Phone:218-227-5503
Practice Address - Fax:218-227-5506
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN215641041C0700X
ND66951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical