Provider Demographics
NPI:1902527328
Name:HINE, KATELYNN (LPC, NCC, MA)
Entity type:Individual
Prefix:
First Name:KATELYNN
Middle Name:
Last Name:HINE
Suffix:
Gender:
Credentials:LPC, NCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 SQUEALER LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-8451
Mailing Address - Country:US
Mailing Address - Phone:843-283-9363
Mailing Address - Fax:
Practice Address - Street 1:2714 SQUEALER LAKE TRL
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-8451
Practice Address - Country:US
Practice Address - Phone:843-283-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101Y00000X
SC10829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor