MEDICARE: DR. STEPHANY L. HILLMAN PHD, MP

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	103TC1900X	Counseling Psychologist	43-696	MS
2	103TC1900X	Counseling Psychologist	1168	LA
3	103TP0016X	Prescribing (Medical) Psychologist	310480	LA

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	:	1427163674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANY L. HILLMAN PHD, MP

Provider Business Mailing Address
First Line	:	6522 W MAIN ST
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70360-2267
Country	:	US
Telephone Number	:	985-804-1521
Fax Number	:	504-636-3923

Provider Business Practice Location Address
First Line	:	6522 W MAIN ST
Second Line	:
City	:	HOUMA
State	:	LA
Zip	:	70360-2267
Country	:	US
Telephone Number	:	985-804-1521
Fax Number	:	504-636-3923

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	12/05/2022

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