Provider Demographics
NPI:1649077470
Name:HINTON, ELAINA NOEL BRISTOL (LMSW)
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:NOEL BRISTOL
Last Name:HINTON
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:ELAINA
Other - Middle Name:NOEL
Other - Last Name:BRISTOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:170 EARLY SUNDOWN RD
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-2114
Mailing Address - Country:US
Mailing Address - Phone:678-262-8963
Mailing Address - Fax:
Practice Address - Street 1:901 TIGER CONNECTOR
Practice Address - Street 2:
Practice Address - City:TIGER
Practice Address - State:GA
Practice Address - Zip Code:30576-2301
Practice Address - Country:US
Practice Address - Phone:706-782-0459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW012144104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker