Provider Demographics
NPI:1831747393
Name:HILL, DESTINY (MS, LAC, LCADC)
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, LAC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S BLACK HORSE PIKE STE 204
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2959
Mailing Address - Country:US
Mailing Address - Phone:856-302-6437
Mailing Address - Fax:
Practice Address - Street 1:141 S BLACK HORSE PIKE STE 204
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2959
Practice Address - Country:US
Practice Address - Phone:856-302-6437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00327400101YP2500X
NJ37AC00414300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty