MEDICARE: SUSAN HILL LCSW

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	101YM0800X	Mental Health Counselor	C004983	NC
2	1041C0700X	Clinical Social Worker	C004983	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124020292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN HILL LCSW

Provider Business Mailing Address
First Line	:	7505 ARGENT VLY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8618
Country	:	US
Telephone Number	:	919-995-7943
Fax Number	:

Provider Business Practice Location Address
First Line	:	ERWIN RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-0001
Country	:	US
Telephone Number	:	919-995-7943
Fax Number	:

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	11/27/2007

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