Provider Demographics
NPI:1548378482
Name:HOPKINS, JOHN CHARLES (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHARLES
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 MADERA DRIVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-2151
Mailing Address - Country:US
Mailing Address - Phone:903-565-5453
Mailing Address - Fax:903-534-6518
Practice Address - Street 1:1810 SHILOH RD
Practice Address - Street 2:SUITE 801
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2419
Practice Address - Country:US
Practice Address - Phone:903-530-6718
Practice Address - Fax:903-534-6518
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245LCOtherBCBS