Healthcare Provider Details

I. General information

NPI: 1144947631
Provider Name (Legal Business Name): JOHN HILL LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BERTHA RD STE B
TAOS NM
87571-7148
US

IV. Provider business mailing address

1803 CARLISLE BLVD NE
ALBUQUERQUE NM
87110-4905
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-4297
  • Fax:
Mailing address:
  • Phone: 505-842-9911
  • Fax: 505-254-9911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: