Basic Information
| Provider Information | |||||||||
| NPI: | 1154926848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HINES | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PYS.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 557 PIT ROAD | ||||||||
| Address2: | |||||||||
| City: | BROWNSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461122604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178582700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 530 W 49TH ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462083480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179409385 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2020 | ||||||||
| LastUpdateDate: | 03/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 20042559A | IN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.