Provider Demographics
NPI:1710344296
Name:HILL, ELISABETH (LPC)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:DU QUOIN
Mailing Address - State:IL
Mailing Address - Zip Code:62832-2442
Mailing Address - Country:US
Mailing Address - Phone:618-542-4357
Mailing Address - Fax:618-542-3442
Practice Address - Street 1:1016 S MADISON ST
Practice Address - Street 2:
Practice Address - City:DU QUOIN
Practice Address - State:IL
Practice Address - Zip Code:62832-2442
Practice Address - Country:US
Practice Address - Phone:618-542-4357
Practice Address - Fax:618-542-3442
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IL178.011909101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor