Provider Demographics
NPI:1700300605
Name:HILL, JENNICA MELISSA (MSSW, LCSW)
Entity type:Individual
Prefix:
First Name:JENNICA
Middle Name:MELISSA
Last Name:HILL
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 COLONEL DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-0070
Mailing Address - Country:US
Mailing Address - Phone:254-350-8997
Mailing Address - Fax:
Practice Address - Street 1:4505 COLONEL DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-0070
Practice Address - Country:US
Practice Address - Phone:254-350-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX533951041C0700X
TN85421041C0700X
WALW613580171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW61358017OtherWASHINGTON STATE DEPARTMENT OF HEALTH
TN8542OtherTENNESSEE BOARD OF SOCIAL WORK LICENSURE
TX53395OtherTEXAS STATE BOARD OF SOCIAL WORK EXAMINERS