Mellicent Fae Hinson, MSW

Individual provider Active NPI Clinical Social Worker · Ruston, WA

NPI 1316628944 · NPPES record last updated Jul 27, 2023

Key facts

NPI
1316628944
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
61396536 (WA)
Practice address
5219 N Shirley St Ste 100
Ruston, WA 98407-6599
Phone
(253) 434-4220
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
61396536WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DBT Center of Tacoma PLLC Clinical Current
since Jul 31, 2023
Accepting new patients
Elizabeth Lotempio, PSYD, PLLC Current
since Jul 31, 2023
Accepting new patients

Locations

5219 N Shirley St
Ste 100
Ruston, WA 98407
Phone (206) 218-3277

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 61396536 WA Yes

Addresses

Primary practice location

5219 N Shirley St Ste 100
Ruston, WA 98407-6599

Mailing address

5219 N Shirley St Ste 100
Ruston, WA 98407-6599
Phone (253) 434-4220

Other providers in Ruston, WA

All providers in Ruston, WA · Clinical Social Worker in Washington

Sources for this page

Verify at the official NPI Registry.