Provider Demographics
NPI:1578222774
Name:ALLYSON HAWKINS, PH.D. PROFESSIONAL COUNSELING SERVICES
Entity Type:Organization
Organization Name:ALLYSON HAWKINS, PH.D. PROFESSIONAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:309-532-0481
Mailing Address - Street 1:2416 E WASHINGTON ST STE A7
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-1612
Mailing Address - Country:US
Mailing Address - Phone:309-532-0481
Mailing Address - Fax:
Practice Address - Street 1:2416 E WASHINGTON ST STE A7
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-1612
Practice Address - Country:US
Practice Address - Phone:309-532-0481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty