Provider Demographics
NPI:1740789957
Name:HILL, KEISA (LPC-I)
Entity Type:Individual
Prefix:
First Name:KEISA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 ZION CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PACOLET
Mailing Address - State:SC
Mailing Address - Zip Code:29372-2929
Mailing Address - Country:US
Mailing Address - Phone:864-398-2380
Mailing Address - Fax:
Practice Address - Street 1:340 ZION CHURCH RD
Practice Address - Street 2:
Practice Address - City:PACOLET
Practice Address - State:SC
Practice Address - Zip Code:29372-2929
Practice Address - Country:US
Practice Address - Phone:864-398-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-03
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional