Basic Information
Provider Information | |||||||||
NPI: | 1376651455 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HILLMAN | ||||||||
FirstName: | ANN | ||||||||
MiddleName: | K | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.S.S.A., LCSW | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2424 S 90TH ST | ||||||||
Address2: | SUITE 502 | ||||||||
City: | WEST ALLIS | ||||||||
State: | WI | ||||||||
PostalCode: | 532272455 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4143295657 | ||||||||
FaxNumber: | 4143295637 | ||||||||
Practice Location | |||||||||
Address1: | 2424 S 90TH ST | ||||||||
Address2: | SUITE 502 | ||||||||
City: | WEST ALLIS | ||||||||
State: | WI | ||||||||
PostalCode: | 532272455 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4143295657 | ||||||||
FaxNumber: | 4143295637 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/28/2006 | ||||||||
LastUpdateDate: | 03/12/2014 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 2035-123 | WI | Y |   | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.