Healthcare Provider Details

I. General information

NPI: 1477868248
Provider Name (Legal Business Name): DOLORES HILL-GLENN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 RIVERSIDE DR UNIT #3
SPRING CITY PA
19475-1840
US

IV. Provider business mailing address

1440 RUSSELL RD
PAOLI PA
19301-1236
US

V. Phone/Fax

Practice location:
  • Phone: 610-644-6464
  • Fax: 610-792-3684
Mailing address:
  • Phone: 610-644-6464
  • Fax: 610-644-4066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCW016152
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: