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NPI Code Detail

MEDICARE: MRS. STACY ROBERTSON HILLENBRAND LCSW

MEDICARE: MRS. STACY ROBERTSON HILLENBRAND 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
11041C0700XClinical Social Worker6427TN

Other Identifiers

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

General Provider Information

NPI Number : 1447692173
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STACY ROBERTSON HILLENBRAND LCSW
Provider Business Mailing Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 1704 E BROADWAY AVE
Second Line :
City : MARYVILLE
State : TN
Zip : 37804-2916
Country : US
Telephone Number : 865-681-6990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2013
Last Update Date : 07/23/2020

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