Healthcare Provider Details

I. General information

NPI: 1811256852
Provider Name (Legal Business Name): WILLIAM KELLY HILL LCPC-5873
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MR. WILLIAM KELLY HILL

II. Dates (important events)

Enumeration Date: 05/11/2012
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1972 E GLENLOCH ST
MERIDIAN ID
83646-5786
US

IV. Provider business mailing address

1972 E GLENLOCH ST
MERIDIAN ID
83646-5786
US

V. Phone/Fax

Practice location:
  • Phone: 208-738-4770
  • Fax:
Mailing address:
  • Phone: 208-995-5329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-5873
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: