Provider Demographics
NPI:1063069185
Name:HILL CITY COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:HILL CITY COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MIKKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:434-258-0591
Mailing Address - Street 1:1610A GRAVES MILL RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4329
Mailing Address - Country:US
Mailing Address - Phone:434-258-0591
Mailing Address - Fax:434-608-0505
Practice Address - Street 1:1610A GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4329
Practice Address - Country:US
Practice Address - Phone:434-258-0591
Practice Address - Fax:434-608-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730524927OtherNPI
1578740924OtherNPI