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NPI 1396302105

NPI 1396302105 : PHILIP JAMES HINMAN LCSW : MANSON, NC

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General NPI Number Information
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    NPI Number           |    1396302105
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    Entity Type          |    Individual 
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    Provider Name        |    PHILIP JAMES HINMAN LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/28/2019
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    Last Update Date     |    05/13/2021
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Provider Practice Location Address
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    Address Line         |    633 SHEPARDS WAY LN 
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    City                 |    MANSON
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    State                |    NC
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    Zip                  |    27553-9673
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    Country              |    US
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    Telephone            |    252-366-9380
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    Fax                  |    336-921-2222
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Provider Business Mailing Address
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    Address Line         |    633 SHEPARDS WAY LN 
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    City                 |    MANSON
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    State                |    NC
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    Zip                  |    27553-9673
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    Country              |    US
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    Telephone            |    252-366-9380
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    Fax                  |    336-921-2222
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    C012151
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    License Number State |    NC
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