Provider Demographics
NPI:1528126513
Name:HILKER, KELLIE A (PHD)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:A
Last Name:HILKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 LOWCOUNTRY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3066
Mailing Address - Country:US
Mailing Address - Phone:615-618-0658
Mailing Address - Fax:
Practice Address - Street 1:913 BOWMAN RD STE 104
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3235
Practice Address - Country:US
Practice Address - Phone:843-216-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2025-03-07
Deactivation Date:2012-09-11
Deactivation Code:
Reactivation Date:2016-02-11
Provider Licenses
StateLicense IDTaxonomies
SC1386103T00000X, 103TB0200X, 103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent