1568670438 NPI number — MS. KRISTINE ANNE POURSINE-HILL LMHC, NCC,CAP

Table of content: MS. KRISTINE ANNE POURSINE-HILL LMHC, NCC,CAP (NPI 1568670438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568670438 NPI number — MS. KRISTINE ANNE POURSINE-HILL LMHC, NCC,CAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POURSINE-HILL
Provider First Name:
KRISTINE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC, NCC,CAP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HILL
Provider Other First Name:
KRISTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CAP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1568670438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1115 PIN OAK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33019-4841
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-920-2554
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5701 HOLLYWOOD BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-6326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-964-0515
Provider Business Practice Location Address Fax Number:
954-964-0521
Provider Enumeration Date:
05/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  2041L , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YM0800X , with the licence number: MH4796 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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