Provider Demographics
NPI:1104014851
Name:HINZE, FREDERICK R (HSP-PA)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:R
Last Name:HINZE
Suffix:
Gender:M
Credentials:HSP-PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1440 OLD LENOIR RD STE B
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2489
Mailing Address - Country:US
Mailing Address - Phone:828-328-9600
Mailing Address - Fax:828-261-0576
Practice Address - Street 1:219A AVERY AVE
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3102
Practice Address - Country:US
Practice Address - Phone:828-430-4388
Practice Address - Fax:828-430-4384
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1303101Y00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist