Provider Demographics
NPI:1548564651
Name:HINSHAW, DIANNA Y (LPC, LADC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:Y
Last Name:HINSHAW
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 NW EXPRESSWAY
Mailing Address - Street 2:BOX 140
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-2601
Mailing Address - Country:US
Mailing Address - Phone:405-496-6314
Mailing Address - Fax:
Practice Address - Street 1:8904 STANFORD CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-2601
Practice Address - Country:US
Practice Address - Phone:405-496-6314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5403101YP2500X
OK1239101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1548564651Medicaid