Provider Demographics
NPI:1982959276
Name:HINES, MANDY LYNN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:LYNN
Last Name:HINES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:MANDY
Other - Middle Name:LYNN
Other - Last Name:MILSTEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:8550 ULMERTON RD
Mailing Address - Street 2:# 145
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-5358
Mailing Address - Country:US
Mailing Address - Phone:727-545-6477
Mailing Address - Fax:
Practice Address - Street 1:8550 ULMERTON RD
Practice Address - Street 2:# 145
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-5358
Practice Address - Country:US
Practice Address - Phone:727-545-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP2500X
FLMH10654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional