Provider Demographics
NPI:1851402333
Name:HINES, VIRGINIA ANN (LCSW, ACSW)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:ANN
Last Name:HINES
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:ANN
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, ACSW, C AD
Mailing Address - Street 1:5822 ROSE SAGE STREET
Mailing Address - Street 2:
Mailing Address - City:N. LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-5004
Mailing Address - Country:US
Mailing Address - Phone:702-657-8750
Mailing Address - Fax:
Practice Address - Street 1:5822 ROSE SAGE ST
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-5004
Practice Address - Country:US
Practice Address - Phone:702-657-8750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4064-C101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)