Provider Demographics
NPI:1881618551
Name:HINE-ST.HILAIRE, DADRENE ANETTA (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:DADRENE
Middle Name:ANETTA
Last Name:HINE-ST.HILAIRE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E GREENWICH AVE
Mailing Address - Street 2:
Mailing Address - City:ROOSEVELT
Mailing Address - State:NY
Mailing Address - Zip Code:11575-1221
Mailing Address - Country:US
Mailing Address - Phone:516-378-6269
Mailing Address - Fax:
Practice Address - Street 1:1370 UNION ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4336
Practice Address - Country:US
Practice Address - Phone:718-455-3629
Practice Address - Fax:718-455-3645
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO23436-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health