Provider Demographics
NPI:1689013500
Name:HAWLEY, JOHN C (LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:HAWLEY
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 1:6501 3RD AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53143-5111
Mailing Address - Country:US
Mailing Address - Phone:262-945-1526
Mailing Address - Fax:
Practice Address - Street 1:6501 3RD AVE STE 1
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53143-5111
Practice Address - Country:US
Practice Address - Phone:262-945-1526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4803-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional