MEDICARE: ISOLDE HILL LPCA

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	288734	KY

General Provider Information

NPI Number	:	1669248928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISOLDE HILL LPCA

Provider Business Mailing Address
First Line	:	204 HARRIER CT
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37042-4846
Country	:	US
Telephone Number	:	931-378-2905
Fax Number	:

Provider Business Practice Location Address
First Line	:	1002 S VIRGINIA ST STE 401
Second Line	:
City	:	HOPKINSVILLE
State	:	KY
Zip	:	42240-3507
Country	:	US
Telephone Number	:	270-881-2142
Fax Number	:

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

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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Directions to “ ISOLDE HILL LPCA” Practice Location

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