Provider Demographics
NPI:1407304082
Name:HAWKINS, MELISSA (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:MISS
Other - First Name:MELISSA
Other - Middle Name:NICOLE
Other - Last Name:WASKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2017 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1472
Mailing Address - Country:US
Mailing Address - Phone:330-507-5434
Mailing Address - Fax:
Practice Address - Street 1:615 CHURCHILL HUBBARD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1332
Practice Address - Country:US
Practice Address - Phone:330-759-2700
Practice Address - Fax:330-759-5415
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1200280-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker