Provider Demographics
NPI:1336266741
Name:HOOKER, GINA A (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:GINA
Middle Name:A
Last Name:HOOKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SEMINOLE BLVD
Mailing Address - Street 2:B-112
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-8173
Mailing Address - Country:US
Mailing Address - Phone:727-518-7294
Mailing Address - Fax:727-584-4937
Practice Address - Street 1:587 S DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6256
Practice Address - Country:US
Practice Address - Phone:727-562-5304
Practice Address - Fax:727-466-0818
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ014BOtherBLUE SHIELD NUMBER