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General NPI Number Information
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NPI Number | 1821548728
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Entity Type | Individual
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Provider Name | VICKIE MARIE LARSON-HILLS MSW LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 340 1ST AVE SE
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City | ALBANY
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State | OR
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Zip | 97321-2738
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Country | US
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Telephone | 360-356-2508
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Fax |
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Provider Business Mailing Address
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Address Line | 510 NE ASPEN ST
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City | SUBLIMITY
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State | OR
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Zip | 97385-9106
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Country | US
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Telephone | 503-509-6223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L7637
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License Number State | OR
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