Provider Demographics
NPI:1942901004
Name:HINKLE, ANDREW (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HINKLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 BAXTER LN APT 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-8056
Mailing Address - Country:US
Mailing Address - Phone:406-529-4408
Mailing Address - Fax:
Practice Address - Street 1:4055 VALLEY COMMONS DR STE H
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6434
Practice Address - Country:US
Practice Address - Phone:406-209-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-626001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical