Provider Demographics
NPI:1750502399
Name:HILEWICK, CAROL LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL LEE
Middle Name:
Last Name:HILEWICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-0068
Mailing Address - Country:US
Mailing Address - Phone:301-649-2411
Mailing Address - Fax:301-649-6089
Practice Address - Street 1:11513 OREBAUGH AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2921
Practice Address - Country:US
Practice Address - Phone:301-649-2411
Practice Address - Fax:301-649-6089
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2131103T00000X, 103TB0200X, 103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
746449Medicare PIN