Provider Demographics
NPI:1013737618
Name:HINE, SHYLEE (MSW, SWC)
Entity type:Individual
Prefix:MS
First Name:SHYLEE
Middle Name:
Last Name:HINE
Suffix:
Gender:F
Credentials:MSW, SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ANITA RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3110
Mailing Address - Country:US
Mailing Address - Phone:719-244-4680
Mailing Address - Fax:
Practice Address - Street 1:6710 S US HIGHWAY 85-87
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1014
Practice Address - Country:US
Practice Address - Phone:719-244-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.0000001647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker