Provider Demographics
NPI:1659520773
Name:HAWKINS, MARY DELAYNE (CRC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:DELAYNE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:CRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1303
Mailing Address - Street 2:
Mailing Address - City:EXMORE
Mailing Address - State:VA
Mailing Address - Zip Code:23350-1303
Mailing Address - Country:US
Mailing Address - Phone:757-442-4590
Mailing Address - Fax:757-442-4593
Practice Address - Street 1:32370 LANKFORD HIGHWAY
Practice Address - Street 2:
Practice Address - City:PAINTER
Practice Address - State:VA
Practice Address - Zip Code:23420
Practice Address - Country:US
Practice Address - Phone:757-442-4590
Practice Address - Fax:757-442-4593
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional