Provider Demographics
NPI:1922682640
Name:HINSON, JENNIFER B (LCSWA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:HINSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4346
Mailing Address - Country:US
Mailing Address - Phone:704-550-1355
Mailing Address - Fax:
Practice Address - Street 1:431 RIDGE ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-4346
Practice Address - Country:US
Practice Address - Phone:980-581-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0160661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical