Provider Demographics
NPI:1538492020
Name:HAWK, PATRICIA KATELYN (LPCC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:KATELYN
Last Name:HAWK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:KATELYN
Other - Last Name:HAWK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:720 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-4413
Mailing Address - Country:US
Mailing Address - Phone:707-268-2900
Mailing Address - Fax:707-476-4070
Practice Address - Street 1:730 HARRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4414
Practice Address - Country:US
Practice Address - Phone:720-363-9260
Practice Address - Fax:707-441-4679
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3000101YP2500X
CO6007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional