Provider Demographics
NPI:1811353451
Name:AVA V HINTON PLLC
Entity type:Organization
Organization Name:AVA V HINTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AVA
Authorized Official - Middle Name:V
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LCASA
Authorized Official - Phone:919-286-3358
Mailing Address - Street 1:312 E ALTON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3005
Mailing Address - Country:US
Mailing Address - Phone:919-286-2283
Mailing Address - Fax:866-433-8408
Practice Address - Street 1:1058 W CLUB BLVD
Practice Address - Street 2:STE 602
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1104
Practice Address - Country:US
Practice Address - Phone:919-286-2283
Practice Address - Fax:866-433-8408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2655-A101YA0400X
NC8759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6604292Medicaid