Provider Demographics
NPI:1760251300
Name:HILL, KHALIF MATTHEW
Entity Type:Individual
Prefix:
First Name:KHALIF
Middle Name:MATTHEW
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 DURHAM CHAPEL HILL BLVD BLDG B
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6239
Mailing Address - Country:US
Mailing Address - Phone:919-719-8344
Mailing Address - Fax:
Practice Address - Street 1:3326 DURHAM-CHAPEL HILL BLVD BUILDING B UNIT 120-B
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-719-8344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0172761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical