Provider Demographics
NPI:1881657229
Name:HILL, PATRICIA ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:REICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:7242 FORESTVIEW LN N
Mailing Address - Street 2:THE COUNSELING SHOP
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5628
Mailing Address - Country:US
Mailing Address - Phone:763-400-7075
Mailing Address - Fax:763-400-7078
Practice Address - Street 1:7242 FORESTVIEW LN N
Practice Address - Street 2:THE COUNSELING SHOP
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5628
Practice Address - Country:US
Practice Address - Phone:763-400-7075
Practice Address - Fax:763-400-7078
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15021104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker