Provider Demographics
NPI:1174323562
Name:HILL, MARY JANE (LCPC CONDITIONAL)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:HILL
Suffix:
Gender:F
Credentials:LCPC CONDITIONAL
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:JANE
Other - Last Name:BILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:ME
Mailing Address - Zip Code:04785-0025
Mailing Address - Country:US
Mailing Address - Phone:207-484-8453
Mailing Address - Fax:
Practice Address - Street 1:6 STATE ST STE 613
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5140
Practice Address - Country:US
Practice Address - Phone:207-307-7704
Practice Address - Fax:207-573-1108
Is Sole Proprietor?:No
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL8029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional