Provider Demographics
NPI:1366556383
Name:HILL, ELIZABETH BOSTON (MSW LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BOSTON
Last Name:HILL
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 PALM SPRINGS DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701
Mailing Address - Country:US
Mailing Address - Phone:407-339-0604
Mailing Address - Fax:407-339-2256
Practice Address - Street 1:631 PALM SPRINGS DRIVE
Practice Address - Street 2:SUITE 107
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-339-0604
Practice Address - Fax:407-339-2256
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
FLSW#3938104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ-6600-AMedicare PIN