MEDICARE: STEPHANY L. HILLMAN, PH.D., LLC

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	103TC1900X	Counseling Psychologist	1168	LA
2	103TP0016X	Prescribing (Medical) Psychologist

General Provider Information

NPI Number	:	1790299287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHANY L. HILLMAN, PH.D., LLC

Provider Business Mailing Address
First Line	:	1817 HARVEST DR
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70360-5909
Country	:	US
Telephone Number	:	985-804-1521
Fax Number	:	504-636-3923

Provider Business Practice Location Address
First Line	:	6522 W MAIN ST
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70360-2267
Country	:	US
Telephone Number	:	985-804-1521
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHANY L HILLMAN
Credential	:	PH.D.
Telephone Number	:	985-804-1521

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	11/13/2022

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