Provider Demographics
NPI:1912059056
Name:HINDS, VICKI LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LYNN
Last Name:HINDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 N ALTA VISTA TER
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2907
Mailing Address - Country:US
Mailing Address - Phone:312-320-8086
Mailing Address - Fax:773-869-3505
Practice Address - Street 1:3257 N SHEFFIELD AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2270
Practice Address - Country:US
Practice Address - Phone:312-320-8086
Practice Address - Fax:773-869-3605
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical