Provider Demographics
NPI:1952008484
Name:HILL, LISA (MCAP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S JEFFERSON ST STE F
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348-4607
Mailing Address - Country:US
Mailing Address - Phone:850-843-6486
Mailing Address - Fax:850-547-6453
Practice Address - Street 1:1000 S JEFFERSON ST STE F
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-4607
Practice Address - Country:US
Practice Address - Phone:850-843-6486
Practice Address - Fax:850-547-6453
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)