Provider Demographics
NPI:1801004999
Name:HAWKINS, PATRICIA J (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:J
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 CROSS BEND ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-7135
Mailing Address - Country:US
Mailing Address - Phone:616-365-8865
Mailing Address - Fax:
Practice Address - Street 1:339 DIVISION AVE S
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4540
Practice Address - Country:US
Practice Address - Phone:616-222-4570
Practice Address - Fax:616-222-4571
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health