MEDICARE: MR. HUEY LEE HAWKINS JR. L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.011431	IL
2	1041C0700X	Clinical Social Worker	149-011431	IL
3	1041C0700X	Clinical Social Worker	2002027247	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063422665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HUEY LEE HAWKINS JR. L.C.S.W.

Provider Business Mailing Address
First Line	:	4311 ROLAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-2523
Country	:	US
Telephone Number	:	314-882-6840
Fax Number	:	314-427-2303

Provider Business Practice Location Address
First Line	:	7700 CLAYTON RD STE 201
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1346
Country	:	US
Telephone Number	:	314-882-6840
Fax Number	:	314-427-2303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	04/28/2020

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Directions to “ MR. HUEY LEE HAWKINS JR. L.C.S.W.” Practice Location

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