Provider Demographics
NPI:1356714265
Name:HILL, JAMES (MA, LSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:MA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 ANGOLA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-4665
Mailing Address - Country:US
Mailing Address - Phone:304-541-7399
Mailing Address - Fax:
Practice Address - Street 1:6756 WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213-7119
Practice Address - Country:US
Practice Address - Phone:304-941-6256
Practice Address - Fax:304-553-0379
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist