Provider Demographics
NPI:1730726944
Name:HAWKINS, AUDRA BARR (LPC)
Entity type:Individual
Prefix:
First Name:AUDRA
Middle Name:BARR
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 1:750 C JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:LULA
Mailing Address - State:GA
Mailing Address - Zip Code:30554-3710
Mailing Address - Country:US
Mailing Address - Phone:770-530-8135
Mailing Address - Fax:
Practice Address - Street 1:750 C JORDAN RD
Practice Address - Street 2:
Practice Address - City:LULA
Practice Address - State:GA
Practice Address - Zip Code:30554-3710
Practice Address - Country:US
Practice Address - Phone:770-530-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009765101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health