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General NPI Number Information
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NPI Number | 1134206535
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Entity Type | Organization
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Legal Business Name | ACACIA CENTER FOR HUMAN GROWTH & DEVELOPMENT, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 819 W FRANKLIN ST
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City | EVANSVILLE
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State | IN
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Zip | 47710-1137
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Country | US
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Telephone | 812-491-1805
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Fax | 812-491-1929
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Provider Business Mailing Address
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Address Line | 819 W FRANKLIN ST
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City | EVANSVILLE
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State | IN
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Zip | 47710-1137
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Country | US
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Telephone | 812-491-1805
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Fax | 812-491-1929
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAROLYN B. HINES
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Credential | PH.D.
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Telephone | 812-491-1805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20041439A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004767A
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License Number State | IN
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