Provider Demographics
NPI:1841154283
Name:HAWKINS, SHANAY KIERRA
Entity type:Individual
Prefix:
First Name:SHANAY
Middle Name:KIERRA
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20080 SEMINOLE RD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2312
Mailing Address - Country:US
Mailing Address - Phone:216-832-4374
Mailing Address - Fax:
Practice Address - Street 1:11401 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5428
Practice Address - Country:US
Practice Address - Phone:216-307-7687
Practice Address - Fax:216-432-7258
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-10
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children