Provider Demographics
NPI:1053452078
Name:HAWLEY, JOHN L JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:HAWLEY
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HAWKINS LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5827
Mailing Address - Country:US
Mailing Address - Phone:703-850-7300
Mailing Address - Fax:703-430-9570
Practice Address - Street 1:6 PIDGEON HILL DR
Practice Address - Street 2:SUITE 260
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6146
Practice Address - Country:US
Practice Address - Phone:703-850-7300
Practice Address - Fax:703-430-9570
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001126103TA0400X, 103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7713649Medicaid
VA214975OtherANTHEM BCBS
VA452614OtherMAMSI UNITEDHEALTHCARE
VA214975OtherANTHEM BCBS