Provider Demographics
NPI:1104371913
Name:HAWBAKER, JASON (LPCA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HAWBAKER
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONG SHOALS RD APT 12D
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-7755
Mailing Address - Country:US
Mailing Address - Phone:910-548-1893
Mailing Address - Fax:
Practice Address - Street 1:300 LONG SHOALS RD APT 12D
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-7755
Practice Address - Country:US
Practice Address - Phone:910-548-1893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12443101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health