Provider Demographics
NPI:1922999507
Name:HINTON, JACQUESE (QMHP)
Entity type:Individual
Prefix:
First Name:JACQUESE
Middle Name:
Last Name:HINTON
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 DUNCAN DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-8761
Mailing Address - Country:US
Mailing Address - Phone:434-713-9946
Mailing Address - Fax:434-888-8508
Practice Address - Street 1:13701 US HIGHWAY 29 STE 3
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-3612
Practice Address - Country:US
Practice Address - Phone:434-433-2056
Practice Address - Fax:434-433-2065
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0732011637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health