Provider Demographics
NPI:1588452320
Name:HINDS, SHANIQUE (MHC-LP)
Entity type:Individual
Prefix:
First Name:SHANIQUE
Middle Name:
Last Name:HINDS
Suffix:
Gender:
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1719
Mailing Address - Country:US
Mailing Address - Phone:347-458-5931
Mailing Address - Fax:
Practice Address - Street 1:55 MAIN ST FL 3
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-2739
Practice Address - Country:US
Practice Address - Phone:914-327-5585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health