Provider Demographics
NPI:1356882229
Name:HILL, DEIDRA ELAINE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DEIDRA
Middle Name:ELAINE
Last Name:HILL
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 1:1500 WATERS PL
Mailing Address - Street 2:WHITE PLAINS ROAD CLINIC
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2723
Mailing Address - Country:US
Mailing Address - Phone:929-348-4407
Mailing Address - Fax:718-944-7184
Practice Address - Street 1:1500 WATERS PL
Practice Address - Street 2:WHITE PLAINS ROAD CLINIC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2723
Practice Address - Country:US
Practice Address - Phone:929-348-4407
Practice Address - Fax:718-944-7184
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator