Provider Demographics
NPI:1114636834
Name:JENNIFER HILLS LCSW PLLC
Entity type:Organization
Organization Name:JENNIFER HILLS LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HILLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:701-340-8982
Mailing Address - Street 1:600 22ND AVE NW STE U2
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-0986
Mailing Address - Country:US
Mailing Address - Phone:701-340-8982
Mailing Address - Fax:701-839-9071
Practice Address - Street 1:600 22ND AVE NW STE U2
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-0986
Practice Address - Country:US
Practice Address - Phone:701-340-8982
Practice Address - Fax:701-839-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1461307Medicaid