Healthcare Provider Details

I. General information

NPI: 1033058748
Provider Name (Legal Business Name): HINES EQ BEHAVIORAL HEALTH COUNSELING & CONSULTATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11590 SEMINOLE BLVD STE A-05
LARGO FL
33778-3204
US

IV. Provider business mailing address

12125 83RD WAY
LARGO FL
33773-2843
US

V. Phone/Fax

Practice location:
  • Phone: 727-206-6004
  • Fax: 866-877-1171
Mailing address:
  • Phone: 727-206-6004
  • Fax: 866-877-1171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MANDY HINES, HINES
Title or Position: OWNER/LMHC
Credential: LMHC
Phone: 727-206-6004