Healthcare Provider Details

I. General information

NPI: 1134206535
Provider Name (Legal Business Name): ACACIA CENTER FOR HUMAN GROWTH & DEVELOPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 W FRANKLIN ST
EVANSVILLE IN
47710-1137
US

IV. Provider business mailing address

819 W FRANKLIN ST
EVANSVILLE IN
47710-1137
US

V. Phone/Fax

Practice location:
  • Phone: 812-491-1805
  • Fax: 812-491-1929
Mailing address:
  • Phone: 812-491-1805
  • Fax: 812-491-1929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20041439A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34004767A
License Number StateIN

VIII. Authorized Official

Name: DR. CAROLYN B. HINES
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 812-491-1805