Provider Demographics
NPI:1821674987
Name:HAWKINSON, SAMANTHA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:HAWKINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7919 PAXTON AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6666
Mailing Address - Country:US
Mailing Address - Phone:708-653-1840
Mailing Address - Fax:
Practice Address - Street 1:18700 WOLF RD STE 220
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8761
Practice Address - Country:US
Practice Address - Phone:708-928-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178016252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional