Provider Demographics
NPI:1720545619
Name:SMITH, HILLARY M (LLMSW)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 PORTAGE ST
Mailing Address - Street 2:STE 111
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-4962
Mailing Address - Country:US
Mailing Address - Phone:269-365-0128
Mailing Address - Fax:
Practice Address - Street 1:4000 PORTAGE ST
Practice Address - Street 2:STE 111
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-4962
Practice Address - Country:US
Practice Address - Phone:269-365-0128
Practice Address - Fax:269-350-5733
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801103808104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker