Provider Demographics
NPI:1801114780
Name:PINE HILL COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:PINE HILL COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:JANEAN
Authorized Official - Last Name:HILLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-705-3575
Mailing Address - Street 1:600 BOULEVARD SOUTH SW
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2113
Mailing Address - Country:US
Mailing Address - Phone:256-705-3575
Mailing Address - Fax:256-705-3515
Practice Address - Street 1:600 BOULEVARD SOUTH SW
Practice Address - Street 2:SUITE 104
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2113
Practice Address - Country:US
Practice Address - Phone:256-705-3575
Practice Address - Fax:256-705-3515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
AL2616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3390Medicaid