Provider Demographics
NPI:1598858003
Name:BINES, SHIRILL H (LPCS)
Entity Type:Individual
Prefix:
First Name:SHIRILL
Middle Name:H
Last Name:BINES
Suffix:
Gender:F
Credentials:LPCS
Other - Prefix:
Other - First Name:SHIRILL
Other - Middle Name:
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PSC 3 BOX 1754
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09021-0018
Mailing Address - Country:US
Mailing Address - Phone:208-218-3086
Mailing Address - Fax:
Practice Address - Street 1:UNIT 33100
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-3100
Practice Address - Country:US
Practice Address - Phone:208-218-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5201S101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103209Medicaid
NC1013025873OtherMENTAL HEALTH