Provider Demographics
NPI:1255678926
Name:HAWKINS, JAMIE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:GELORMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:109 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-1040
Mailing Address - Country:US
Mailing Address - Phone:631-901-7769
Mailing Address - Fax:
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082765104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYGEOFF8231OtherNORTHPORT VA MEDICAL CENTER