Provider Demographics
NPI:1689615338
Name:HAWKINS, VICKI JO (LMSW)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:JO
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:VICKI
Other - Middle Name:JO
Other - Last Name:CASWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3960 PATIENT CARE WAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4275
Mailing Address - Country:US
Mailing Address - Phone:517-887-9801
Mailing Address - Fax:517-887-9826
Practice Address - Street 1:3960 PATIENT CARE WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4275
Practice Address - Country:US
Practice Address - Phone:517-887-9801
Practice Address - Fax:517-887-9826
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010657451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical