Provider Demographics
NPI:1720242738
Name:HAWKINS, JOHN ROBERT JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROBERT
Last Name:HAWKINS
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 4TH AVE S STE 16
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39701-5755
Mailing Address - Country:US
Mailing Address - Phone:662-435-0050
Mailing Address - Fax:888-391-8125
Practice Address - Street 1:413 4TH AVE S STE 16
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39701-5755
Practice Address - Country:US
Practice Address - Phone:662-435-0050
Practice Address - Fax:888-391-8125
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0895101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional