Healthcare Provider Details

I. General information

NPI: 1902387699
Provider Name (Legal Business Name): AMY MICHELE HILLMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY M STOGNER MSW, LCSW

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 04/16/2024
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 COLUMBIA ST
BOGALUSA LA
70427-4720
US

IV. Provider business mailing address

542 COLUMBIA ST
BOGALUSA LA
70427-4720
US

V. Phone/Fax

Practice location:
  • Phone: 985-735-9448
  • Fax:
Mailing address:
  • Phone: 985-735-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5629
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number5629
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: