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General NPI Number Information
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NPI Number | 1639443344
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Entity Type | Individual
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Provider Name | TASHA LAVON HINSON LISW-CP LCAS-A
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Gender | Female
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 604 GREGG AVE
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City | FLORENCE
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State | SC
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Zip | 29501-4317
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Country | US
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Telephone | 843-319-1345
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 642
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City | CHERAW
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State | SC
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Zip | 29520-0642
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Country | US
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Telephone | 843-319-1345
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Fax |
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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 | LCAS-20083
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License Number State | NC
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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 | 9285
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License Number State | SC
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