Provider Demographics
NPI:1891031464
Name:HINTON, AVA VERNELL (LPC)
Entity Type:Individual
Prefix:MS
First Name:AVA
Middle Name:VERNELL
Last Name:HINTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E ALTON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3005
Mailing Address - Country:US
Mailing Address - Phone:919-358-3621
Mailing Address - Fax:
Practice Address - Street 1:1058 W CLUB BLVD
Practice Address - Street 2:SUITE #614
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1104
Practice Address - Country:US
Practice Address - Phone:919-358-3621
Practice Address - Fax:919-560-1197
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-29
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional