Healthcare Provider Details

I. General information

NPI: 1538438775
Provider Name (Legal Business Name): CYNTHIA D HILL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 FOOTE ST
CORINTH MS
38834-4834
US

IV. Provider business mailing address

PO BOX 839
CORINTH MS
38835-0839
US

V. Phone/Fax

Practice location:
  • Phone: 662-287-4424
  • Fax: 662-287-2070
Mailing address:
  • Phone: 662-286-9883
  • Fax: 662-286-9836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberW3767
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: