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General NPI Number Information
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NPI Number | 1376194191
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Entity Type | Individual
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Provider Name | ANNA HINES MSW, LCSWA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2019
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 518 SIGNAL HILL DRIVE EXT
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City | STATESVILLE
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State | NC
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Zip | 28625-4391
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Country | US
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Telephone | 704-871-9605
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Fax | 704-873-9917
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Provider Business Mailing Address
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Address Line | 284 EXECUTIVE PARK DR STE 100
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City | CONCORD
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State | NC
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Zip | 28025-1833
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Country | US
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Telephone | 704-939-1100
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Fax | 704-939-1173
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | P014075
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P014075
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | P014075
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | P014075
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | P014075
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | P014075
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | P014075
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | P014075
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License Number State | NC
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Taxonomy #9
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | P014075
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License Number State | NC
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Taxonomy #10
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P014075
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License Number State | NC
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