Healthcare Provider Details

I. General information

NPI: 1720763204
Provider Name (Legal Business Name): KATIE DAWN HAWKINS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 N MAIN ST
BISHOP CA
93514-3013
US

IV. Provider business mailing address

1360 N MAIN ST
BISHOP CA
93514-3013
US

V. Phone/Fax

Practice location:
  • Phone: 760-873-6533
  • Fax:
Mailing address:
  • Phone: 760-873-6533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW137903
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: