Provider Demographics
NPI:1922106038
Name:DEAN-HILL, JACOB ALLAN (LICSW)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:ALLAN
Last Name:DEAN-HILL
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 KEENE RD
Mailing Address - Street 2:BUILDING H
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7751
Mailing Address - Country:US
Mailing Address - Phone:509-366-8318
Mailing Address - Fax:509-735-4971
Practice Address - Street 1:1950 KEENE RD
Practice Address - Street 2:BUILDING H
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-7751
Practice Address - Country:US
Practice Address - Phone:509-366-8318
Practice Address - Fax:509-735-4971
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000090221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical