Provider Demographics
NPI:1770888521
Name:HAWKINS, AMANDA L (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:L
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SAVAGE CT
Mailing Address - Street 2:
Mailing Address - City:FALLING WATERS
Mailing Address - State:WV
Mailing Address - Zip Code:25419-1509
Mailing Address - Country:US
Mailing Address - Phone:240-778-3419
Mailing Address - Fax:
Practice Address - Street 1:53 SAVAGE CT
Practice Address - Street 2:
Practice Address - City:FALLING WATERS
Practice Address - State:WV
Practice Address - Zip Code:25419-1509
Practice Address - Country:US
Practice Address - Phone:240-778-3419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD160261041C0700X
WVDP009458381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical