MEDICARE: LORETTA HILL LCSW INC.

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	2483	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	433767219	OTHER	LA	VERITY
2	175926	OTHER	LA	MHNET
3	377800	OTHER	LA	VALUE OPTIONS
4	1417227919	OTHER	LA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1467862623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORETTA HILL LCSW INC.

Provider Business Mailing Address
First Line	:	1651 THIBODEAUX AVE
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8271
Country	:	US
Telephone Number	:	225-926-4009
Fax Number	:	225-926-4069

Provider Business Practice Location Address
First Line	:	1651 THIBODEAUX AVE
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8271
Country	:	US
Telephone Number	:	225-926-4009
Fax Number	:	225-926-4069

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	MRS. LORETTA G HILL
Credential	:	LCSW
Telephone Number	:	225-926-4009

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	04/28/2014

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