Provider Demographics
NPI:1245108893
Name:HINES, MELISSA J (LPCC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:J
Last Name:HINES
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 10TH AVE S UPPR
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-4132
Mailing Address - Country:US
Mailing Address - Phone:952-217-3511
Mailing Address - Fax:
Practice Address - Street 1:970 RAYMOND AVE STE 204
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1164
Practice Address - Country:US
Practice Address - Phone:612-296-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional