MEDICARE: MAURA ANNE HINES LCSW

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	1041C0700X	Clinical Social Worker	44SC05456200	NJ

General Provider Information

NPI Number	:	1275985921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURA ANNE HINES LCSW

Provider Business Mailing Address
First Line	:	3138 POWHATAN AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-3565
Country	:	US
Telephone Number	:	201-321-2702
Fax Number	:

Provider Business Practice Location Address
First Line	:	3138 POWHATAN AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-3565
Country	:	US
Telephone Number	:	201-321-2702
Fax Number	:

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

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	07/06/2016

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