Provider Demographics
NPI:1124387782
Name:HINDS, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HINDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FRANKLIN ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2011
Mailing Address - Country:US
Mailing Address - Phone:518-381-8911
Mailing Address - Fax:518-377-4292
Practice Address - Street 1:530 FRANKLIN ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12305-2011
Practice Address - Country:US
Practice Address - Phone:518-381-8911
Practice Address - Fax:518-377-4292
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 086290104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY051104000053OtherFIDELIS
NY02664359Medicaid