Provider Demographics
NPI:1073681698
Name:HYNES, CATHERINE M (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:M
Last Name:HYNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PORTSMOUTH AVE STE 1
Mailing Address - Street 2:PMB 259
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-6528
Mailing Address - Country:US
Mailing Address - Phone:207-835-1750
Mailing Address - Fax:
Practice Address - Street 1:2099B NH ROUTE 140
Practice Address - Street 2:
Practice Address - City:GILMANTON IW
Practice Address - State:NH
Practice Address - Zip Code:03837-4849
Practice Address - Country:US
Practice Address - Phone:207-835-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432408099Medicaid