Healthcare Provider Details

I. General information

NPI: 1033695788
Provider Name (Legal Business Name): CARRIE L HINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 05/31/2020
Certification Date: 05/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N CHEYENNE AVE
SILVER CITY NM
88061-3725
US

IV. Provider business mailing address

PO BOX 453
SILVER CITY NM
88062-0453
US

V. Phone/Fax

Practice location:
  • Phone: 970-270-2851
  • Fax: 970-628-4991
Mailing address:
  • Phone: 970-270-2851
  • Fax: 970-628-4991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.00000606
License Number StateCO

VIII. Authorized Official

Name: CARRIE L HINDS
Title or Position: OWNER
Credential: LCSW
Phone: 970-270-2851