Provider Demographics
NPI:1871696062
Name:HILL, TAREN A (LMSW)
Entity type:Individual
Prefix:
First Name:TAREN
Middle Name:A
Last Name:HILL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TAREN
Other - Middle Name:ALICIA
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88202-1978
Mailing Address - Country:US
Mailing Address - Phone:505-623-1480
Mailing Address - Fax:
Practice Address - Street 1:109 W BLAND ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-5708
Practice Address - Country:US
Practice Address - Phone:505-623-1480
Practice Address - Fax:505-622-3325
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-05680104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker