Provider Demographics
NPI:1790562924
Name:HILLS, JAMES WILBUR III (LAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILBUR
Last Name:HILLS
Suffix:III
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4639 W PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8813
Mailing Address - Country:US
Mailing Address - Phone:479-259-1439
Mailing Address - Fax:
Practice Address - Street 1:2105 S 54TH ST STE 2
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8191
Practice Address - Country:US
Practice Address - Phone:479-373-2377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2011158101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health