Provider Demographics
NPI:1508053059
Name:HAWKINS, HOMER (LMSW)
Entity Type:Individual
Prefix:
First Name:HOMER
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S WAVERLY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-3631
Mailing Address - Country:US
Mailing Address - Phone:517-321-5900
Mailing Address - Fax:517-321-5945
Practice Address - Street 1:302 S WAVERLY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-3631
Practice Address - Country:US
Practice Address - Phone:517-321-5900
Practice Address - Fax:517-321-5945
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010158691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical