Provider Demographics
NPI:1770331571
Name:HAWKS, CELESTE BOLES
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:BOLES
Last Name:HAWKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 ROCK HILL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ARARAT
Mailing Address - State:NC
Mailing Address - Zip Code:27007-8308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:765 ROCK HILL CHURCH RD
Practice Address - Street 2:
Practice Address - City:ARARAT
Practice Address - State:NC
Practice Address - Zip Code:27007-8308
Practice Address - Country:US
Practice Address - Phone:336-710-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health