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General NPI Number Information
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NPI Number | 1922999507
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Entity Type | Individual
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Provider Name | JACQUESE HINTON QMHP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 13701 US HIGHWAY 29 STE 3
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City | CHATHAM
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State | VA
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Zip | 24531-3612
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Country | US
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Telephone | 434-433-2056
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Fax | 434-433-2065
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Provider Business Mailing Address
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Address Line | 1145 DUNCAN DR
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City | DANVILLE
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State | VA
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Zip | 24541-8761
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Country | US
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Telephone | 434-713-9946
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Fax | 434-888-8508
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0732011637
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License Number State | VA
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