Provider Demographics
NPI:1891316774
Name:HAWKINSON, ANNAROSE (LICSW)
Entity type:Individual
Prefix:
First Name:ANNAROSE
Middle Name:
Last Name:HAWKINSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 AMORY ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2310
Mailing Address - Country:US
Mailing Address - Phone:617-286-4134
Mailing Address - Fax:
Practice Address - Street 1:222 FORBES RD STE 207
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2720
Practice Address - Country:US
Practice Address - Phone:781-428-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223297104100000X
MA1232971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker