Provider Demographics
NPI:1124412846
Name:HAWES, ANDERSON R (LPCC, LSW)
Entity Type:Individual
Prefix:
First Name:ANDERSON
Middle Name:R
Last Name:HAWES
Suffix:
Gender:M
Credentials:LPCC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 RAVENSHOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2895
Mailing Address - Country:US
Mailing Address - Phone:330-329-8425
Mailing Address - Fax:
Practice Address - Street 1:272 RAVENSHOLLOW DR
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2895
Practice Address - Country:US
Practice Address - Phone:330-329-8425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC.84168-CSSR101YA0400X
OHE.002550-SUPV101YM0800X
OHS.0009491104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker