Destiny Hill, MS, LAC, LCADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00414300 Issued in NJ

Practice address

141 S Black Horse Pike Ste 204
Blackwood, NJ 08012-2959

Phone

(856) 302-6437

NPI assigned

Aug 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Stanford CTC Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Blackwood, NJ
  • NPI 1699247635
  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1831747393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 S BLACK HORSE PIKE STE 204",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122959",
            "telephone_number": "856-302-6437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 S BLACK HORSE PIKE STE 204",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122959",
            "telephone_number": "856-302-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "DESTINY",
        "credential": "MS, LAC, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37LC00327400",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00414300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haven Detox NJ Operating Subsidiary, LLC
• Haven Detox of New Jersey LLC
• Shaymaa Shakor Hebatallah
• Brian Heist, DO
• Helping Hands Caring Hearts
• Dashnay Holmes
• Victoria Horan
• Audrey Jane Iacobucci, MD
• Robert Iannace Jr., LAC, NCC
• Joseph Michael Iannelli III, DC

• Professional Counselor in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.