Provider Demographics
NPI:1427163674
Name:HILLMAN, STEPHANY L (PHD, MP)
Entity type:Individual
Prefix:DR
First Name:STEPHANY
Middle Name:L
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:PHD, MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6522 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2267
Mailing Address - Country:US
Mailing Address - Phone:985-804-1521
Mailing Address - Fax:504-636-3923
Practice Address - Street 1:6522 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2267
Practice Address - Country:US
Practice Address - Phone:985-804-1521
Practice Address - Fax:504-636-3923
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS43-696103TC1900X
LA1168103TC1900X
LA310480103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2513311Medicaid