Healthcare Provider Details

I. General information

NPI: 1801114780
Provider Name (Legal Business Name): PINE HILL COUNSELING AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BOULEVARD SOUTH SW SUITE 104
HUNTSVILLE AL
35802-2113
US

IV. Provider business mailing address

600 BOULEVARD SOUTH SW SUITE 104
HUNTSVILLE AL
35802-2113
US

V. Phone/Fax

Practice location:
  • Phone: 256-705-3575
  • Fax: 256-705-3515
Mailing address:
  • Phone: 256-705-3575
  • Fax: 256-705-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2616
License Number StateAL

VIII. Authorized Official

Name: SUZANNE JANEAN HILLIN
Title or Position: EXECUTIVE DIRECTOR/COUNSELOR
Credential: LPC
Phone: 256-705-3575