Provider Demographics
NPI:1154591550
Name:HINES, DENISE RENEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:RENEE
Last Name:HINES
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 1:625 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5405
Mailing Address - Country:US
Mailing Address - Phone:817-681-5768
Mailing Address - Fax:
Practice Address - Street 1:413 W BETHEL RD STE 100
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4474
Practice Address - Country:US
Practice Address - Phone:972-393-1596
Practice Address - Fax:972-304-0400
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical