Healthcare Provider Details

I. General information

NPI: 1376952135
Provider Name (Legal Business Name): JANE HILL PHD, LPC, LMHC QS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANE HILL PHD, LPC, LMHC QS

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SARNO RD STE 24
MELBOURNE FL
32935-4993
US

IV. Provider business mailing address

1600 SARNO RD SUITE 24
MELBOURNE FL
32935
US

V. Phone/Fax

Practice location:
  • Phone: 321-252-5195
  • Fax: 321-490-6004
Mailing address:
  • Phone: 321-252-5195
  • Fax: 321-490-6004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number70539
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number70539
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16107
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH16107
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: