Provider Demographics
NPI:1780697391
Name:HINKELL, VIOLETTA D (LICSW)
Entity type:Individual
Prefix:MRS
First Name:VIOLETTA
Middle Name:D
Last Name:HINKELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MYRTLE STREET
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104
Mailing Address - Country:US
Mailing Address - Phone:603-668-0014
Mailing Address - Fax:603-623-7676
Practice Address - Street 1:161 MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:KEEN
Practice Address - State:NH
Practice Address - Zip Code:03431-3722
Practice Address - Country:US
Practice Address - Phone:603-357-3093
Practice Address - Fax:603-623-7676
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1157104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30428429Medicaid