Provider Demographics
NPI:1972669869
Name:HILLS, CAUDIA (MA LPC)
Entity Type:Individual
Prefix:MISS
First Name:CAUDIA
Middle Name:
Last Name:HILLS
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 AUSTELL POWDER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-3315
Mailing Address - Country:US
Mailing Address - Phone:770-948-9088
Mailing Address - Fax:770-948-9090
Practice Address - Street 1:5655 AUSTELL POWDER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-3315
Practice Address - Country:US
Practice Address - Phone:770-948-9088
Practice Address - Fax:770-948-9090
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA169297130AMedicaid