Provider Demographics
NPI:1699035105
Name:HINES, SHERRI (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:HINES
Suffix:
Gender:F
Credentials:MS, LPC
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 887
Mailing Address - Street 2:304 SW 10TH ST.
Mailing Address - City:PREMONT
Mailing Address - State:TX
Mailing Address - Zip Code:78375-0887
Mailing Address - Country:US
Mailing Address - Phone:361-877-6162
Mailing Address - Fax:361-348-2433
Practice Address - Street 1:304 SW 10TH ST.
Practice Address - Street 2:
Practice Address - City:PREMONT
Practice Address - State:TX
Practice Address - Zip Code:78375-0887
Practice Address - Country:US
Practice Address - Phone:361-877-6162
Practice Address - Fax:361-348-2433
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66414101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional