Provider Demographics
NPI:1245075845
Name:HILL, SHACORI (QMHP -A/C)
Entity type:Individual
Prefix:
First Name:SHACORI
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:QMHP -A/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 FOREHAND DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2006
Mailing Address - Country:US
Mailing Address - Phone:757-861-9020
Mailing Address - Fax:
Practice Address - Street 1:2856 FOREHAND DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2006
Practice Address - Country:US
Practice Address - Phone:757-861-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2007101YA0400X
VA0732005844171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator