Provider Demographics
NPI:1861756751
Name:HINES, SHANNON M (LMSW, CSWE)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:M
Last Name:HINES
Suffix:
Gender:F
Credentials:LMSW, CSWE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2115
Mailing Address - Country:US
Mailing Address - Phone:406-750-1414
Mailing Address - Fax:
Practice Address - Street 1:510 1ST AVE N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-2592
Practice Address - Country:US
Practice Address - Phone:406-454-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical