Provider Demographics
NPI:1891486957
Name:HOPPER, MINDY RAINES (LCSW)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:RAINES
Last Name:HOPPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 ENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-3945
Mailing Address - Country:US
Mailing Address - Phone:731-267-7187
Mailing Address - Fax:
Practice Address - Street 1:2400 ENVILLE RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-3945
Practice Address - Country:US
Practice Address - Phone:731-267-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker