Provider Demographics
NPI:1861288433
Name:TESTAMARK-HILL, CHANTE SIMONE
Entity type:Individual
Prefix:MS
First Name:CHANTE
Middle Name:SIMONE
Last Name:TESTAMARK-HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SWEETSPIRE DR NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2329
Mailing Address - Country:US
Mailing Address - Phone:678-387-7943
Mailing Address - Fax:
Practice Address - Street 1:17 SWEETSPIRE DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2329
Practice Address - Country:US
Practice Address - Phone:678-387-7943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty