Provider Demographics
NPI:1275049843
Name:HAWLEY, GERARD LEE (LPC)
Entity Type:Individual
Prefix:MR
First Name:GERARD
Middle Name:LEE
Last Name:HAWLEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 LITZELMAN RD
Mailing Address - Street 2:
Mailing Address - City:DUSHORE
Mailing Address - State:PA
Mailing Address - Zip Code:18614-8059
Mailing Address - Country:US
Mailing Address - Phone:570-928-1098
Mailing Address - Fax:570-928-1098
Practice Address - Street 1:1048 LITZELMAN RD
Practice Address - Street 2:
Practice Address - City:DUSHORE
Practice Address - State:PA
Practice Address - Zip Code:18614-8059
Practice Address - Country:US
Practice Address - Phone:570-928-1098
Practice Address - Fax:570-928-1098
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional