Healthcare Provider Details

I. General information

NPI: 1427004662
Provider Name (Legal Business Name): JANICE I HILL MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7405 UNIVERSITY AVE SUITE 6
CLIVE IA
50325-1343
US

IV. Provider business mailing address

7405 UNIVERSITY AVE SUITE 6
CLIVE IA
50325-1343
US

V. Phone/Fax

Practice location:
  • Phone: 515-277-6991
  • Fax: 515-277-6995
Mailing address:
  • Phone: 515-277-6991
  • Fax: 515-277-6995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLISW 337
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier38792
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerNPI PROVIDER NUMBER

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: