Provider Demographics
NPI:1114993649
Name:HAWKINS-BEATTY, LETITIA RENEE (LPC)
Entity Type:Individual
Prefix:
First Name:LETITIA
Middle Name:RENEE
Last Name:HAWKINS-BEATTY
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 1:5650 HOLLINS RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-5056
Mailing Address - Country:US
Mailing Address - Phone:540-265-8923
Mailing Address - Fax:540-265-7663
Practice Address - Street 1:5650 HOLLINS RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-5056
Practice Address - Country:US
Practice Address - Phone:540-265-8923
Practice Address - Fax:540-265-7663
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003535101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945263Medicaid
VA085948MOtherSENTARA
VA2182273OtherCIGNA
VI269011OtherANTHEM
VA269011OtherHEATHKEEPERS
VA566992000OtherMAGELLAN