Provider Demographics
NPI:1912287707
Name:HINES, DENNIS WAYNE (LPC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:WAYNE
Last Name:HINES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 VIA CORDOVA
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4612
Mailing Address - Country:US
Mailing Address - Phone:469-964-1011
Mailing Address - Fax:
Practice Address - Street 1:1075 KINWEST PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3426
Practice Address - Country:US
Practice Address - Phone:972-910-8388
Practice Address - Fax:972-910-8388
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional