Provider Demographics
NPI:1982725420
Name:HAWKINS, LENDORA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LENDORA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 HARRISON ST
Mailing Address - Street 2:SUITE # 380
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2969
Mailing Address - Country:US
Mailing Address - Phone:219-980-1971
Mailing Address - Fax:219-980-1972
Practice Address - Street 1:6111 HARRISON ST
Practice Address - Street 2:SUITE # 380
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2969
Practice Address - Country:US
Practice Address - Phone:219-980-1971
Practice Address - Fax:219-980-1972
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004686A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN215410Medicare ID - Type Unspecified