Provider Demographics
NPI:1053863829
Name:HAWKINS, BRIANNE (LCMHC, LCAS-A)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LCMHC, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25661
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27114-5661
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:3331 HEALY DRIVE
Practice Address - Street 2:UNIT 25661
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27114
Practice Address - Country:US
Practice Address - Phone:336-422-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS23124101YA0400X
NCA12527101YP2500X
NC12527101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional