Provider Demographics
NPI:1467798017
Name:HAWKINS, TAMMY DENISE (LCAS,CCS)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:DENISE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LCAS,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-0506
Mailing Address - Country:US
Mailing Address - Phone:910-324-4887
Mailing Address - Fax:866-436-3503
Practice Address - Street 1:1007 HARGETT ST STE 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5940
Practice Address - Country:US
Practice Address - Phone:910-324-4887
Practice Address - Fax:866-436-3503
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1534101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6112278Medicaid