Healthcare Provider Details

I. General information

NPI: 1144130170
Provider Name (Legal Business Name): KENYA S HAWKINS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 W HARRISON ST
CHICAGO IL
60644-5101
US

IV. Provider business mailing address

5300 S SHORE DR APT 32
CHICAGO IL
60615-5719
US

V. Phone/Fax

Practice location:
  • Phone: 312-465-9721
  • Fax:
Mailing address:
  • Phone: 312-465-9721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.023429
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: