Provider Demographics
NPI:1629314851
Name:HINES, JOAN ROSE (LPC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:ROSE
Last Name:HINES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 RICCI CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-1484
Mailing Address - Country:US
Mailing Address - Phone:678-640-3300
Mailing Address - Fax:
Practice Address - Street 1:10 PARK PLACE SOUTH SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2913
Practice Address - Country:US
Practice Address - Phone:404-839-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-16
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACCAADC-C0075101YA0400X
GALPC006107101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)