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Organization

GAYNELL DENISE HILL, LCSW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE HILL (LCSW)
(912) 536-1643
Entity
Organization

Contact information

Practice address
207 LEE DR, STATESBORO, GA 30461-6844
(912) 536-1643
Mailing address
207 LEE DR, STATESBORO, GA 30461-6844
(912) 536-1643

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1041C0700X
Clinical Social Worker
Primary
CSW004147
GA
171M00000X
Case Manager/Care Coordinator
221700000X
Art Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
138139219B
GA
Enumeration date
11/09/2016
Last updated
11/09/2016
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