Provider Demographics
NPI:1922464593
Name:HILL, PATRICK (LCAS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 SAMARITAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-7908
Mailing Address - Country:US
Mailing Address - Phone:910-895-3243
Mailing Address - Fax:910-895-8612
Practice Address - Street 1:136 SAMARITAN DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-7908
Practice Address - Country:US
Practice Address - Phone:910-895-3243
Practice Address - Fax:910-895-8612
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3166101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)