Basic Information
Provider Information
NPI: 1669759635
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: THOMAS
MiddleName: WARREN
NamePrefix: MR.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11059 E BETHANY DR
Address2:  
City: AURORA
State: CO
PostalCode: 800142622
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Practice Location
Address1: 11059 E BETHANY DR
Address2:  
City: AURORA
State: CO
PostalCode: 800142622
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Other Information
ProviderEnumerationDate: 11/04/2011
LastUpdateDate: 04/27/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2011WVN Behavioral Health & Social Service ProvidersCounselorProfessional
101YP2500XLPC.0012369COY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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