Healthcare Provider Details

I. General information

NPI: 1215798475
Provider Name (Legal Business Name): SHAKERA HAWKINS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 S MILLEDGE AVE STE 1A
ATHENS GA
30605-1292
US

IV. Provider business mailing address

745 S MILLEDGE AVE STE 1A
ATHENS GA
30605-1292
US

V. Phone/Fax

Practice location:
  • Phone: 706-498-9560
  • Fax: 706-498-9568
Mailing address:
  • Phone: 706-498-9560
  • Fax: 706-498-9568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT002172
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: