Provider Demographics
NPI:1326583626
Name:HINES, REBECCA JEAN (LPCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:HINES
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JEAN
Other - Last Name:MCBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:32 10TH AVE S STE 212
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9481
Mailing Address - Country:US
Mailing Address - Phone:952-562-4116
Mailing Address - Fax:763-717-8049
Practice Address - Street 1:904 MAINSTREET
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-7529
Practice Address - Country:US
Practice Address - Phone:952-562-4116
Practice Address - Fax:763-717-8049
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN02477101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCC02477OtherMN BOARD OF BEHAVIORAL HEALTH AND THERAPY