Provider Demographics
NPI:1144493438
Name:HILL, TRACI A (LPC)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:A
Last Name:HILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 NW 58TH ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4707
Mailing Address - Country:US
Mailing Address - Phone:405-651-4298
Mailing Address - Fax:405-778-6258
Practice Address - Street 1:3555 NW 58TH ST
Practice Address - Street 2:SUITE 140
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4707
Practice Address - Country:US
Practice Address - Phone:405-651-4298
Practice Address - Fax:405-778-6258
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2412101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor