Provider Demographics
NPI:1134454598
Name:HILTON, LISA (LMSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HILTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42450 W 12 MILE RD
Mailing Address - Street 2:STE 315
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3030
Mailing Address - Country:US
Mailing Address - Phone:248-513-4100
Mailing Address - Fax:248-513-4105
Practice Address - Street 1:22255 GREENFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3710
Practice Address - Country:US
Practice Address - Phone:248-849-3301
Practice Address - Fax:248-849-5349
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2018-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010921581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical