Provider Demographics
NPI:1578230165
Name:HINTZ, JAVIN-MACHAIAS (MSW, LICSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JAVIN-MACHAIAS
Middle Name:
Last Name:HINTZ
Suffix:
Gender:M
Credentials:MSW, LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-0664
Mailing Address - Country:US
Mailing Address - Phone:651-560-3139
Mailing Address - Fax:
Practice Address - Street 1:225 2ND ST N STE 105
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5000
Practice Address - Country:US
Practice Address - Phone:608-630-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN253871041C0700X
WI95941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical