Provider Demographics
NPI:1356580146
Name:HAIN, JOHN (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:HAIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 W MARVIN AVE
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2933
Mailing Address - Country:US
Mailing Address - Phone:972-923-0156
Mailing Address - Fax:972-923-0156
Practice Address - Street 1:1203 W MARVIN AVE
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2933
Practice Address - Country:US
Practice Address - Phone:972-923-0156
Practice Address - Fax:972-923-0156
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC00791101Y00000X, 101YP2500X, 106H00000X
TXLCSW0383101YM0800X, 102L00000X, 104100000X, 103K00000X
TXLCSW003831041C0700X
TXLMFT00561106H00000X
TXLCSW00791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst