Provider Demographics
NPI:1932268315
Name:HINSON, BRUCE MITCHELL (MA)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:MITCHELL
Last Name:HINSON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 ESCALANTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-2388
Mailing Address - Country:US
Mailing Address - Phone:541-968-5345
Mailing Address - Fax:
Practice Address - Street 1:135 E 6TH AVE # 109
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2618
Practice Address - Country:US
Practice Address - Phone:541-682-3973
Practice Address - Fax:541-968-3967
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR92-R-01101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)