Provider Demographics
NPI:1831435155
Name:HILL, SYRETTA IRENE (MS, CASAC)
Entity type:Individual
Prefix:MS
First Name:SYRETTA
Middle Name:IRENE
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 GRAND STREET
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-6204
Mailing Address - Country:US
Mailing Address - Phone:845-562-7244
Mailing Address - Fax:845-245-4477
Practice Address - Street 1:PO BOX 2066
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-0250
Practice Address - Country:US
Practice Address - Phone:845-562-7244
Practice Address - Fax:845-245-4477
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091148-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker