Provider Demographics
NPI:1194544841
Name:HAWKINS, LYDIA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:MARIE
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 1:2 PROFESSIONAL CT SW STE E
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2832
Mailing Address - Country:US
Mailing Address - Phone:706-389-4068
Mailing Address - Fax:
Practice Address - Street 1:2 PROFESSIONAL CT SW STE E
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2832
Practice Address - Country:US
Practice Address - Phone:706-389-4068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0088491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical