Provider Demographics
NPI:1417200825
Name:HILL, NICOLE REILLY (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:REILLY
Last Name:HILL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OLD OAK DR
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-3022
Mailing Address - Country:US
Mailing Address - Phone:860-235-0290
Mailing Address - Fax:
Practice Address - Street 1:200 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1599
Practice Address - Country:US
Practice Address - Phone:860-768-4482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3598103TC0700X
NH1273103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical