Provider Demographics
NPI:1174097604
Name:HAWKINS, CRYSTAL A (MED LPC CANDIDATE)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:A
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MED LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 WARRINER CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-5657
Mailing Address - Country:US
Mailing Address - Phone:405-343-7865
Mailing Address - Fax:
Practice Address - Street 1:802 NE 19TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-6302
Practice Address - Country:US
Practice Address - Phone:405-912-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health