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NPI Code Detail

MEDICARE: STACI HINES LLMSW

MEDICARE: STACI HINES LLMSW
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
1101Y00000XCounselorFL
21041C0700XClinical Social Worker6801097817MI
31041C0700XClinical Social WorkerSW19723FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811449770
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACI HINES LLMSW
Provider Business Mailing Address
First Line : 5010 HOLLYWOOD BLVD # 5012
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6557
Country : US
Telephone Number : 954-266-2999
Fax Number :
Provider Business Practice Location Address
First Line : 168 N POWERLINE RD
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33069-5713
Country : US
Telephone Number : 954-970-8805
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2016
Last Update Date : 09/09/2025

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