Provider Demographics
NPI:1457966152
Name:HAWKS, MICHELLE M (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:HAWKS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4398
Mailing Address - Country:US
Mailing Address - Phone:321-704-0494
Mailing Address - Fax:
Practice Address - Street 1:107 WAKEFIELD DR
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4398
Practice Address - Country:US
Practice Address - Phone:321-704-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18349101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health