Provider Demographics
NPI:1154926848
Name:HINES, STEVEN (PYSD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:HINES
Suffix:
Gender:M
Credentials:PYSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 PIT ROAD
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2604
Mailing Address - Country:US
Mailing Address - Phone:317-858-2700
Mailing Address - Fax:
Practice Address - Street 1:530 W 49TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-3480
Practice Address - Country:US
Practice Address - Phone:317-940-9385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042559A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical