Provider Demographics
NPI:1588954176
Name:PATTY HILL, INC
Entity type:Organization
Organization Name:PATTY HILL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:763-229-4933
Mailing Address - Street 1:7242 FORESTVIEW LN N
Mailing Address - Street 2:THE COUNSELING SHOP
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5628
Mailing Address - Country:US
Mailing Address - Phone:763-400-7075
Mailing Address - Fax:763-400-7078
Practice Address - Street 1:7242 FORESTVIEW LN N
Practice Address - Street 2:THE COUNSELING SHOP
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5628
Practice Address - Country:US
Practice Address - Phone:763-400-7075
Practice Address - Fax:763-400-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN150211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty