Provider Demographics
NPI:1720478688
Name:HAWKINS-DOOZAN, NICOLE (LMSW, CAADC, ADS)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HAWKINS-DOOZAN
Suffix:
Gender:F
Credentials:LMSW, CAADC, ADS
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:DOOZAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2803 WEISS ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3560
Mailing Address - Country:US
Mailing Address - Phone:517-402-0913
Mailing Address - Fax:
Practice Address - Street 1:2803 WEISS ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3560
Practice Address - Country:US
Practice Address - Phone:989-220-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801095993101YA0400X, 104100000X
MI68011083891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker