Provider Demographics
NPI:1598393118
Name:HINER, LAWRENCE EDWARD III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:EDWARD
Last Name:HINER
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:HINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:272 MINERAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2308
Mailing Address - Country:US
Mailing Address - Phone:916-709-0737
Mailing Address - Fax:
Practice Address - Street 1:272 MINERAL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2308
Practice Address - Country:US
Practice Address - Phone:916-709-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
751OtherNBCC