Individual provider Active NPI

Paul Frederick Hillebert, LCSWC-C, LCADC

  • Clinical Social Worker
  • Hagerstown, MD
National Provider Identifier
1104135532
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12722 Issued in MD
Practice address
28 S Potomac St
#305
Hagerstown, MD 21740-6194
Phone
(240) 469-9991
NPI assigned
Oct 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA418 MD
Clinical Social Worker 1041C0700X 12722 MD Primary

Addresses

Primary practice location

28 S Potomac St
#305
Hagerstown, MD 21740-6194

Mailing address

55 S Potomac St Apt 301
Hagerstown, MD 21740-5537
Phone (240) 469-9991

Other identifiers 1

IdentifierTypeStateIssuer
442810200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12722MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul F. Hillebert Addiction (Substance Use Disorder) Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1104135532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 S POTOMAC ST APT 301",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405537",
            "telephone_number": "240-469-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 S POTOMAC ST",
            "address_2": "#305",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406194",
            "telephone_number": "240-469-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLEBERT",
        "first_name": "PAUL",
        "middle_name": "FREDERICK",
        "credential": "LCSWC-C, LCADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-04",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA418",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "442810200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.