Provider Demographics
NPI:1558157271
Name:HAWKINS, JAKE (LICSW)
Entity type:Individual
Prefix:
First Name:JAKE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24393 COUNTY ROAD 7
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTA
Mailing Address - State:MN
Mailing Address - Zip Code:56301-7702
Mailing Address - Country:US
Mailing Address - Phone:320-282-3119
Mailing Address - Fax:
Practice Address - Street 1:24393 COUNTY ROAD 7
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTA
Practice Address - State:MN
Practice Address - Zip Code:56301-7702
Practice Address - Country:US
Practice Address - Phone:320-282-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN309781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical