Provider Demographics
NPI:1902684863
Name:HANKINS, JOHN LOGAN (LSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LOGAN
Last Name:HANKINS
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MILLS ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9424
Mailing Address - Country:US
Mailing Address - Phone:303-898-9661
Mailing Address - Fax:
Practice Address - Street 1:601 MILLS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-9424
Practice Address - Country:US
Practice Address - Phone:303-898-9661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099246681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical