Provider Demographics
NPI:1992416309
Name:HILL, TIM (EDD, LPC)
Entity type:Individual
Prefix:DR
First Name:TIM
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4448 CORNER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2732
Mailing Address - Country:US
Mailing Address - Phone:402-980-0156
Mailing Address - Fax:
Practice Address - Street 1:4448 CORNER BROOK LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2732
Practice Address - Country:US
Practice Address - Phone:402-980-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional