Provider Demographics
NPI:1417506163
Name:HAWKINS, SHELBY RAYE (LPC-INTERN)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:RAYE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:MISS
Other - First Name:SHELBY
Other - Middle Name:RAYE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6922 ROSELAND DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2714
Mailing Address - Country:US
Mailing Address - Phone:803-609-4350
Mailing Address - Fax:
Practice Address - Street 1:4818 EVERHART RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2738
Practice Address - Country:US
Practice Address - Phone:361-334-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82556101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor