MEDICARE: MS. VICKIE R HILL CADCII

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	06681-C	NV
2	172V00000X	Community Health Worker	5507	NV

General Provider Information

NPI Number	:	1235516378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKIE R HILL CADCII

Provider Business Mailing Address
First Line	:	1388 E. DESERT INN RD.
Second Line	:	UNIT 1
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89169
Country	:	US
Telephone Number	:	404-621-9693
Fax Number	:

Provider Business Practice Location Address
First Line	:	931 S 3RD ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6801
Country	:	US
Telephone Number	:	702-268-7522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2015
Last Update Date	:	06/23/2024

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