Healthcare Provider Details

I. General information

NPI: 1972420396
Provider Name (Legal Business Name): CARL HAWKINS BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 LOWREY PL
NEWINGTON CT
06111-3003
US

IV. Provider business mailing address

123 LOWREY PL
NEWINGTON CT
06111-3003
US

V. Phone/Fax

Practice location:
  • Phone: 860-233-3033
  • Fax:
Mailing address:
  • Phone: 860-233-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2382
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: