Provider Demographics
NPI:1326744400
Name:HINES, CASSANDRA (LMSW)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:HINES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CASSIE
Other - Middle Name:
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:3906 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-8268
Mailing Address - Country:US
Mailing Address - Phone:870-918-8635
Mailing Address - Fax:
Practice Address - Street 1:2200 FORT ROOTS DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:870-918-8635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10071-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker