Healthcare Provider Details

I. General information

NPI: 1235927658
Provider Name (Legal Business Name): TRACEY HINDS LCSW, LMSW, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2025
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 W WINDSOR DR
MARION IN
46952-2616
US

IV. Provider business mailing address

1110 W WINDSOR DR
MARION IN
46952-2616
US

V. Phone/Fax

Practice location:
  • Phone: 765-382-9477
  • Fax:
Mailing address:
  • Phone: 765-382-9477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33011858A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33011858A
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3971026
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: