Individual
SHANNON HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 S PRESTON ST, LOUISVILLE, KY 40202-1716
(502) 583-3951
Mailing address
600 S PRESTON ST, LOUISVILLE, KY 40202-1716
(502) 583-3951
(502) 581-9234
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
3849
KY
1041C0700X
Clinical Social Worker
Primary
3283
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100379300
—
KY
Enumeration date
07/29/2008
Last updated
01/17/2023
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