Provider Demographics
NPI:1801577721
Name:HILL, REGINALD A (PLPC)
Entity type:Individual
Prefix:MR
First Name:REGINALD
Middle Name:A
Last Name:HILL
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844715
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-4715
Mailing Address - Country:US
Mailing Address - Phone:417-761-5214
Mailing Address - Fax:
Practice Address - Street 1:18593 BUSINESS HWY 13
Practice Address - Street 2:SUITE 104-106
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737
Practice Address - Country:US
Practice Address - Phone:417-761-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024040513101YP2500X
OR23-QMHP-R-2184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional