Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 23971 | NY |
Y | 1041C0700X | Clinical Social Worker | 090164-01 | NY |
NPI | 1003254426 |
---|---|
Provider Name | Jason Louchery Hill |
First Address | New York, NY 10032-3809 |
Second Address | New York, NY 10032-3809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 19/04/2021 |