Individual
KIMBERLY ALICE HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1250 E MARSHALL ST, PSYCHIATRY, RICHMOND, VA 23298-5051
(804) 828-3129
(804) 828-7814
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005557
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010206588
—
VA
05
—
010234166
—
VA
05
—
010234468
—
VA
05
—
010319277
—
VA
01
—
196817
ANTHEM
VA
01
—
196818
ANTHEM
VA
01
—
O802755M
OPTIMA HEALTH
VA
Enumeration date
09/14/2006
Last updated
05/14/2012
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