Provider Demographics
NPI:1518367028
Name:HAWKINS, MYRTLE (LPC)
Entity type:Individual
Prefix:
First Name:MYRTLE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 FM 157 APT 326
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6539
Mailing Address - Country:US
Mailing Address - Phone:972-854-9864
Mailing Address - Fax:
Practice Address - Street 1:200 GREENE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-6327
Practice Address - Country:US
Practice Address - Phone:972-854-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68900101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty