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NPI Code Detail

MEDICARE: MRS. CARRIE JAYNE HINNANT MA, CCC-SLP, BCBA

MEDICARE: MRS. CARRIE JAYNE HINNANT MA, CCC-SLP, BCBA
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
1235Z00000XSpeech-Language Pathologist
2103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114039463OTHERAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION CERTIFICATE OF CLINICAL COMPETENCY
25309OTHERSCSC SLP LICENSE
31-24-74068OTHERBOARD CERTIFIED BEHAVIOR ANALYST
411182OTHERNCNC SLP LICENSE

General Provider Information

NPI Number : 1750623104
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE JAYNE HINNANT MA, CCC-SLP, BCBA
Provider Business Mailing Address
First Line : 1698 HIGHWAY 160 W STE 240
Second Line :
City : FORT MILL
State : SC
Zip : 29708-8035
Country : US
Telephone Number : 704-654-8599
Fax Number : 980-938-6088
Provider Business Practice Location Address
First Line : 1698 HIGHWAY 160 W STE 240
Second Line :
City : FORT MILL
State : SC
Zip : 29708-8035
Country : US
Telephone Number : 704-654-8599
Fax Number : 980-938-6088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 08/08/2024

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Directions to “ MRS. CARRIE JAYNE HINNANT MA, CCC-SLP, BCBA” Practice Location

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