Healthcare Provider Details

I. General information

NPI: 1427881960
Provider Name (Legal Business Name): TASHEENA HINDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3911 MARY ELIZA TRCE NW STE 200
MARIETTA GA
30064-1088
US

IV. Provider business mailing address

3911 MARY ELIZA TRCE NW STE 200
MARIETTA GA
30064-1088
US

V. Phone/Fax

Practice location:
  • Phone: 678-631-9907
  • Fax:
Mailing address:
  • Phone: 678-631-9907
  • Fax: 678-701-7909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAMFT000830
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT000830
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT000830
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: