Healthcare Provider Details

I. General information

NPI: 1134745771
Provider Name (Legal Business Name): ASHSTON CHRISTOPHER HAWKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9418 BROOKLINE AVE STE A
BATON ROUGE LA
70809-1428
US

IV. Provider business mailing address

9418 BROOKLINE AVE STE A
BATON ROUGE LA
70809-1428
US

V. Phone/Fax

Practice location:
  • Phone: 225-372-2693
  • Fax:
Mailing address:
  • Phone: 225-610-9927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: