MEDICARE: LATOYA VIOLA HINDS LCSW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1942466370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA VIOLA HINDS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 351
Second Line	:	SILVER STREET
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-7023
Country	:	US
Telephone Number	:	860-262-5244
Fax Number	:	860-262-5290

Provider Business Practice Location Address
First Line	:	399 SILVER STREET
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-7023
Country	:	US
Telephone Number	:	860-262-5244
Fax Number	:	860-262-5290

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

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	08/20/2016

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