Provider Demographics
NPI:1013928175
Name:HINDS, CHARLES K (LMFT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:K
Last Name:HINDS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WEST 100 SOUTH
Mailing Address - Street 2:STE 130
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321
Mailing Address - Country:US
Mailing Address - Phone:435-752-4646
Mailing Address - Fax:435-755-0579
Practice Address - Street 1:95 WEST 100 SOUTH
Practice Address - Street 2:STE 130
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321
Practice Address - Country:US
Practice Address - Phone:435-752-4646
Practice Address - Fax:435-755-0579
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist