Provider Demographics
NPI:1538311477
Name:HAWK, AMBER C
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:C
Last Name:HAWK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E HILL AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37915-2566
Mailing Address - Country:US
Mailing Address - Phone:865-633-9844
Mailing Address - Fax:
Practice Address - Street 1:900 E HILL AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37915-2566
Practice Address - Country:US
Practice Address - Phone:865-633-9844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3013231Medicaid
TN3697678OtherMEDICARE