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General NPI Number Information
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NPI Number | 1073478442
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Entity Type | Organization
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Legal Business Name | L JEAN HINES
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 839 MAIN ST STE 500
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City | LAFAYETTE
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State | IN
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Zip | 47901-2830
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Country | US
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Telephone | 765-427-8019
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Fax | 765-374-2752
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Provider Business Mailing Address
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Address Line | 10918 S SPRINGBORO RD
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City | BROOKSTON
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State | IN
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Zip | 47923-8277
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Country | US
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Telephone | 765-427-8019
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Fax | 765-374-2752
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Authorized Official
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Title or Position | OWNER
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Name | JEAN HINES
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Credential | LCSW
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Telephone | 765-427-8019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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