Provider Demographics
NPI:1447223300
Name:HAWES, CAROL L (LISW SOTP II)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:HAWES
Suffix:
Gender:F
Credentials:LISW SOTP II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 MILITARY ROAD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-1715
Mailing Address - Country:US
Mailing Address - Phone:712-252-4547
Mailing Address - Fax:712-252-3785
Practice Address - Street 1:1601 MILITARY ROAD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51103-1715
Practice Address - Country:US
Practice Address - Phone:712-252-4547
Practice Address - Fax:712-252-3785
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00659104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA08249OtherWELLMARK