Provider Demographics
NPI:1033884382
Name:HILL, COURTNEY ANN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:ANN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3320 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-3552
Mailing Address - Country:US
Mailing Address - Phone:850-381-3744
Mailing Address - Fax:
Practice Address - Street 1:3320 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-3552
Practice Address - Country:US
Practice Address - Phone:850-381-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111934800Medicaid
FLMH19204Medicaid