Basic Information
Provider Information
NPI: 1013264977
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HINKELMAN
FirstName: JOAN
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: LISW-S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6753 STATE RD
Address2:  
City: PARMA
State: OH
PostalCode: 441344517
CountryCode: US
TelephoneNumber: 4408435622
FaxNumber: 4408431626
Practice Location
Address1: 6753 STATE RD
Address2:  
City: PARMA
State: OH
PostalCode: 441344517
CountryCode: US
TelephoneNumber: 4408435622
FaxNumber: 4408431626
Other Information
ProviderEnumerationDate: 08/10/2012
LastUpdateDate: 08/10/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XI.0900017OHY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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