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General NPI Number Information
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NPI Number | 1881170959
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Entity Type | Organization
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Legal Business Name | JERMAINE HILL LCSW FAMILY SERVICES PC
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 60 BAY ST STE 710
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City | STATEN ISLAND
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State | NY
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Zip | 10301-2541
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Country | US
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Telephone | 347-881-3407
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Fax | 718-816-0048
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Provider Business Mailing Address
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Address Line | 67 RAILROAD AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-4734
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Country | US
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Telephone | 718-689-2950
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Fax | 718-816-0048
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Authorized Official
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Title or Position | CEO
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Name | MR. JERMAINE K HILL
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Credential | LCSW
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Telephone | 347-881-3407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 086300-1
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License Number State | NY
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