Provider Demographics
NPI:1659667616
Name:HAWKINS, DIANE JONES (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:JONES
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 OLD EMMORTON RD
Mailing Address - Street 2:SUITE 119
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6187
Mailing Address - Country:US
Mailing Address - Phone:410-569-9497
Mailing Address - Fax:410-569-0094
Practice Address - Street 1:9504 SELBY PL
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-2913
Practice Address - Country:US
Practice Address - Phone:757-447-4947
Practice Address - Fax:410-569-0094
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904005351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker