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1705 S Fort Hood Street Suite 103b Killeen TX 76542-1680 | |
| (254) 239-1029 | |
| (254) 200-2453 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1705 S Fort Hood Street, Killeen, Texas |
| Authorized Official Name and Position | Lewis Nelson Hill (DIRECTOR/OWNER) |
| Authorized Official Contact | 2542391027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1705 S Fort Hood Street Suite 103b Killeen TX 76542-1680 Ph: (254) 239-1029 | 1705 S Fort Hood Street Suite 103b Killeen TX 76542-1680 Ph: (254) 239-1029 |
| NPI Number | 1619413747 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Medicare PECOS PAC ID | 3173057908 |
|---|---|
| Medicare Enrollment ID | O20241115000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619413747 | NPI | - | NPPES |
| 288739001 | Medicaid | TX | |
| 288739002 | Other | TX | CSHCN |
| 368414401 | Medicaid | TX | |
| 368414402 | Other | TX | CHSCN |
| 3684144 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC 58845 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | LPC 58845 (Texas) | Primary |
| Provider Name | Lewis Hill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447525894 PECOS PAC ID: 2961936794 Enrollment ID: I20241115000644 |
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