Provider Demographics
NPI:1659520815
Name:LAINIE HINNANT, LCSW LLC
Entity Type:Organization
Organization Name:LAINIE HINNANT, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAINIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HINNANT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-643-3512
Mailing Address - Street 1:1630 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2427
Mailing Address - Country:US
Mailing Address - Phone:804-643-3512
Mailing Address - Fax:804-423-6455
Practice Address - Street 1:1630 HUGUENOT RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2427
Practice Address - Country:US
Practice Address - Phone:804-643-3512
Practice Address - Fax:804-423-6455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040031041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA355761OtherBCBS
VA1261315OtherAETNA
VA355761OtherBCBS