Healthcare Provider Details

I. General information

NPI: 1346801131
Provider Name (Legal Business Name): TERRY L HINES M.ED., MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 E MAIN ST
MOREHEAD KY
40351-1622
US

IV. Provider business mailing address

2250 THUNDERSTICK DR
LEXINGTON KY
40505-9010
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-1035
  • Fax: 859-254-2075
Mailing address:
  • Phone: 859-254-1035
  • Fax: 859-254-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number254231
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: