Provider Demographics
NPI:1346277944
Name:HAWTHORNE, WILLIAM JOSEPH III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:HAWTHORNE
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PENN CENTER BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5441
Mailing Address - Country:US
Mailing Address - Phone:412-825-5149
Mailing Address - Fax:412-533-3325
Practice Address - Street 1:201 PENN CENTER BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5441
Practice Address - Country:US
Practice Address - Phone:412-242-3050
Practice Address - Fax:412-533-3325
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-004929-L103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018171220001Medicaid
PA725196Medicare ID - Type UnspecifiedMEDICARE & BCBS
PA0018171220001Medicaid