Provider Demographics
NPI:1902436199
Name:HILL, SCOTT
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18003 WOODSFIELD RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-1392
Mailing Address - Country:US
Mailing Address - Phone:740-732-5988
Mailing Address - Fax:740-732-4154
Practice Address - Street 1:18003 WOODSFIELD RD STE 2
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-1392
Practice Address - Country:US
Practice Address - Phone:740-732-5988
Practice Address - Fax:740-732-4154
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRA.162195405300000X
OHCDCA.172829101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No405300000XOther Service ProvidersPrevention Professional