Provider Demographics
NPI:1003827627
Name:HAWKINS, CARLA D (LPC)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:D
Last Name:HAWKINS
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 1:747 LAUREN PKWY
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3483
Mailing Address - Country:US
Mailing Address - Phone:678-576-3824
Mailing Address - Fax:770-469-2838
Practice Address - Street 1:747 LAUREN PKWY
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3483
Practice Address - Country:US
Practice Address - Phone:678-576-3824
Practice Address - Fax:770-469-2838
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003303101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA205339263AMedicaid