MEDICARE: MR. RICHARD STEPHEN HILL L.C.S.W., L.M.F.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34002254	IN
2	106H00000X	Marriage & Family Therapist	35000814	IN

General Provider Information

NPI Number	:	1114107646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD STEPHEN HILL L.C.S.W., L.M.F.T.

Provider Business Mailing Address
First Line	:	7311 POLLARD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2138
Country	:	US
Telephone Number	:	317-213-0907
Fax Number	:

Provider Business Practice Location Address
First Line	:	7311 POLLARD ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2138
Country	:	US
Telephone Number	:	317-213-0907
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	11/13/2007

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