Provider Demographics
NPI:1811907231
Name:HAWKINS, KOREY L (PHD LPC)
Entity type:Individual
Prefix:
First Name:KOREY
Middle Name:L
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:PHD LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 E FOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5216
Mailing Address - Country:US
Mailing Address - Phone:602-672-3114
Mailing Address - Fax:480-396-0532
Practice Address - Street 1:1237 S VAL VISTA DR
Practice Address - Street 2:SUITE 124
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6401
Practice Address - Country:US
Practice Address - Phone:480-776-3366
Practice Address - Fax:480-396-0532
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC- 2318101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health