Individual provider Active NPI

Christiana Hines

  • Mental Health Counselor
  • Avondale, AZ
National Provider Identifier
1023776572
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-19809 Issued in AZ
Practice address
950 E Van Buren St
Avondale, AZ 85323-1506
Phone
(623) 687-1199
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X LPC-19809 AZ Primary

Addresses

Primary practice location

950 E Van Buren St
Avondale, AZ 85323-1506

Mailing address

16887 W Central St
Surprise, AZ 85388-1518

Other identifiers 1

IdentifierTypeStateIssuer
0000000000OtherAZOTHER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104003678 AZ Practitioner - Mental Health Counselor 2567813496 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-19809AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Maricopa County Special Health Care District Current Accepting new patients
Maricopa County Special Health Care District CurrentSince Jan 1, 2024 Accepting new patients
Maricopa County Special Health Care District CurrentSince Jan 1, 2024 Accepting new patients

Locations

950 E Van Buren St
Avondale, AZ 85323
Phone (623) 344-6800

8088 W Whitney Dr
Ste 2A
Peoria, AZ 85345
Phone (833) 855-9973

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1023776572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16887 W CENTRAL ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853881518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E VAN BUREN ST",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853231506",
            "telephone_number": "623-687-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "CHRISTIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-19809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "0000000000",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.