Provider Demographics
NPI:1447556717
Name:HINT, KELLY M (LMHC, NCC, CCMHC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:M
Last Name:HINT
Suffix:
Gender:F
Credentials:LMHC, NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2697 REDS LN
Mailing Address - Street 2:
Mailing Address - City:PIFFARD
Mailing Address - State:NY
Mailing Address - Zip Code:14533-9792
Mailing Address - Country:US
Mailing Address - Phone:585-310-8255
Mailing Address - Fax:
Practice Address - Street 1:2697 REDS LN
Practice Address - Street 2:
Practice Address - City:PIFFARD
Practice Address - State:NY
Practice Address - Zip Code:14533-9792
Practice Address - Country:US
Practice Address - Phone:585-310-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005920101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health