Provider Demographics
NPI:1609447028
Name:HINES, CHRISTINE NICOLE (CADC, LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:NICOLE
Last Name:HINES
Suffix:
Gender:F
Credentials:CADC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 STEWARTON CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4075
Mailing Address - Country:US
Mailing Address - Phone:302-304-9827
Mailing Address - Fax:
Practice Address - Street 1:256 CHAPMAN RD STE 105-2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5499
Practice Address - Country:US
Practice Address - Phone:302-689-3562
Practice Address - Fax:302-294-1757
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1894101Y00000X
DEQ3-0010515101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor