Provider Demographics
NPI:1639443344
Name:HINSON, TASHA LAVON (LISW-CP LCAS-A)
Entity Type:Individual
Prefix:MS
First Name:TASHA
Middle Name:LAVON
Last Name:HINSON
Suffix:
Gender:F
Credentials:LISW-CP LCAS-A
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 642
Mailing Address - Street 2:
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-0642
Mailing Address - Country:US
Mailing Address - Phone:843-319-1345
Mailing Address - Fax:
Practice Address - Street 1:604 GREGG AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4317
Practice Address - Country:US
Practice Address - Phone:843-319-1345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20083101YA0400X
SC92851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)