Provider Demographics
NPI:1952688376
Name:HAWKINS, JASON (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:M
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 1:915 W GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1723
Mailing Address - Country:US
Mailing Address - Phone:269-948-8041
Mailing Address - Fax:269-948-9319
Practice Address - Street 1:915 W GREEN ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1723
Practice Address - Country:US
Practice Address - Phone:269-948-8041
Practice Address - Fax:269-948-9319
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012195101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist