MEDICARE: MRS. TERRAH PAULINE HINSON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2616	NC
2	101YP2500X	Professional Counselor	2616	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1018R	OTHER	NC	BCBSOFNC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	102883858	OTHER	NC	UNITED BEHAVIOR HEALTH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215908280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRAH PAULINE HINSON LPC

Provider Business Mailing Address
First Line	:	1114 TANGLE LN
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9141
Country	:	US
Telephone Number	:	336-883-0275
Fax Number	:	336-889-7005

Provider Business Practice Location Address
First Line	:	1114 TANGLE LN
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9141
Country	:	US
Telephone Number	:	336-883-0275
Fax Number	:	336-889-7005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	08/28/2007

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