Provider Demographics
NPI:1780951343
Name:HINMAN, BRAD (LPC, NCC, LLMFT)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:
Last Name:HINMAN
Suffix:
Gender:M
Credentials:LPC, NCC, LLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W FERRY ST
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1177
Mailing Address - Country:US
Mailing Address - Phone:269-471-5968
Mailing Address - Fax:
Practice Address - Street 1:107 W FERRY ST
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1177
Practice Address - Country:US
Practice Address - Phone:269-471-5968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional