Provider Demographics
NPI:1932276052
Name:HILL, STEPHEN H (PHD, PLLC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:H
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5218
Mailing Address - Country:US
Mailing Address - Phone:208-385-0888
Mailing Address - Fax:208-385-0024
Practice Address - Street 1:1517 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5218
Practice Address - Country:US
Practice Address - Phone:208-385-0888
Practice Address - Fax:208-385-0024
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY-388103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010028916OtherREGENCE BLUE SHIELD OF ID
IDN4734OtherBLUE CROSS OF IDAHO