Provider Demographics
NPI:1114498805
Name:HINES, SALIMA (BSW, MSW)
Entity Type:Individual
Prefix:MS
First Name:SALIMA
Middle Name:
Last Name:HINES
Suffix:
Gender:F
Credentials:BSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 LAKESIDE PT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-0951
Mailing Address - Country:US
Mailing Address - Phone:770-549-8853
Mailing Address - Fax:770-728-0135
Practice Address - Street 1:325 LAKESIDE PT
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-0951
Practice Address - Country:US
Practice Address - Phone:770-549-8853
Practice Address - Fax:770-728-0135
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health