Christy Jalisa Hines

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P014630 Issued in NC

Practice address

3117 Poplarwood CT Ste 350
Raleigh, NC 27604-6446

Phone

(919) 790-8085

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mind & Body Therapeutic Services PLLC

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1770331423
  NPD Authorized official

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1346852845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 LOW GROUND RD",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238476726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 POPLARWOOD CT STE 350",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046446",
            "telephone_number": "919-790-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "CHRISTY",
        "middle_name": "JALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Hoffman Hilts, MS, CCC-SLP
• Millicent Lorsee Himes
• Paul R Hinchey, MD
• Verenda Joyce Hindman, CRNA
• Kaydian Hinds
• Jacqueline Kelli Hines
• Jayla Hines
• Lakia Hudgins Hines, LCSW
• Latasha Deree Hines, AGACNP
• Gregory Colin Hinn, M.D.

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.