Provider Demographics
NPI:1285003921
Name:HAWLEY, DESIREE CHERIE (PSYD)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:CHERIE
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:DESIREE
Other - Middle Name:CHERIE
Other - Last Name:BUSSON-SOKOLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:111 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3220
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 DEAN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3220
Practice Address - Country:US
Practice Address - Phone:815-344-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008902103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical