Provider Demographics
NPI:1043719891
Name:HAWN THERAPY AND CONSULTING, LLC
Entity Type:Organization
Organization Name:HAWN THERAPY AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-415-2593
Mailing Address - Street 1:411 E LAKE AVE APT B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2548
Mailing Address - Country:US
Mailing Address - Phone:919-282-7376
Mailing Address - Fax:
Practice Address - Street 1:405 ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4256
Practice Address - Country:US
Practice Address - Phone:919-282-7376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1770622367OtherBCBS