Provider Demographics
NPI:1730211236
Name:HINES, LINDA S (LPC, LADC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:HINES
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 NW REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-1310
Mailing Address - Country:US
Mailing Address - Phone:580-248-0844
Mailing Address - Fax:580-248-5651
Practice Address - Street 1:2307 NW REDWOOD LN
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-1310
Practice Address - Country:US
Practice Address - Phone:580-248-0844
Practice Address - Fax:580-248-5651
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK115101YA0400X
OK628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional