Provider Demographics
NPI:1457711483
Name:HILL, CANDI (PHD, MP)
Entity Type:Individual
Prefix:DR
First Name:CANDI
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:PHD, MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 STUBBS AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5628
Mailing Address - Country:US
Mailing Address - Phone:318-323-8700
Mailing Address - Fax:318-323-8757
Practice Address - Street 1:1502 STUBBS AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5628
Practice Address - Country:US
Practice Address - Phone:318-323-8700
Practice Address - Fax:318-323-8757
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1322103TC1900X
LA324799103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling