Basic Information
Provider Information
NPI: 1558634949
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HINTON
FirstName: ASHLEY
MiddleName: V
NamePrefix: MS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 457 RUTLAND ST
Address2:  
City: WESTBURY
State: NY
PostalCode: 115902312
CountryCode: US
TelephoneNumber: 5163078114
FaxNumber:  
Practice Location
Address1: 175 FULTON AVE
Address2:  
City: HEMPSTEAD
State: NY
PostalCode: 115503718
CountryCode: US
TelephoneNumber: 5164855710
FaxNumber: 5164854225
Other Information
ProviderEnumerationDate: 02/15/2012
LastUpdateDate: 02/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X0854311NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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