Provider Demographics
NPI:1275985921
Name:HINES, MAURA ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:ANNE
Last Name:HINES
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 1:3138 POWHATAN AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-3565
Mailing Address - Country:US
Mailing Address - Phone:201-321-2702
Mailing Address - Fax:
Practice Address - Street 1:3138 POWHATAN AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-3565
Practice Address - Country:US
Practice Address - Phone:201-321-2702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054562001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical