Provider Demographics
NPI:1508680943
Name:HINEBAUGH, CASEY (MA)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:HINEBAUGH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 CRENSHAW RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2002
Mailing Address - Country:US
Mailing Address - Phone:541-255-6776
Mailing Address - Fax:
Practice Address - Street 1:1776 MILLRACE DR STE 202
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-2589
Practice Address - Country:US
Practice Address - Phone:541-861-7956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health