MEDICARE: JULIE NICOLA HILL LPC, MHSP

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
2	101YP2500X	Professional Counselor		TN

General Provider Information

NPI Number	:	1649313610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE NICOLA HILL LPC, MHSP

Provider Business Mailing Address
First Line	:	2181 BOBOLINK TRL
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-6032
Country	:	US
Telephone Number	:	731-967-2392
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 UNION AVENUE EXT
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-4436
Country	:	US
Telephone Number	:	731-967-2392
Fax Number	:

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	12/31/2013

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