Provider Demographics
NPI:1154848760
Name:HAKES, MICHAEL L JR
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:L
Last Name:HAKES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 E CROSIER ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-2151
Mailing Address - Country:US
Mailing Address - Phone:330-996-7296
Mailing Address - Fax:
Practice Address - Street 1:264 EAST CROSIER STREET
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311
Practice Address - Country:US
Practice Address - Phone:330-996-7296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162454101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)