Provider Demographics
NPI:1992495774
Name:HINMAN, JADE-HEATHER MARANDA (MSW)
Entity type:Individual
Prefix:
First Name:JADE-HEATHER
Middle Name:MARANDA
Last Name:HINMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JADE-HEATHER
Other - Middle Name:MARANDA
Other - Last Name:ACKERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:POPLAR
Mailing Address - State:MT
Mailing Address - Zip Code:59255-0002
Mailing Address - Country:US
Mailing Address - Phone:406-450-2769
Mailing Address - Fax:
Practice Address - Street 1:307 N 2ND ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3616
Practice Address - Country:US
Practice Address - Phone:406-214-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-573481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical