MEDICARE: DEBORAH JANE HINDMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6401009688	MI
2	101YP2500X	Professional Counselor
3	101YP2500X	Professional Counselor	6401009688	MI

General Provider Information

NPI Number	:	1255894358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH JANE HINDMAN

Provider Business Mailing Address
First Line	:	1915 WAITE AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49008-1760
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 WAITE AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49008-1760
Country	:	US
Telephone Number	:	269-377-6060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	04/08/2019

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Directions to “ DEBORAH JANE HINDMAN ” Practice Location

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