Healthcare Provider Details

I. General information

NPI: 1891608105
Provider Name (Legal Business Name): HAWKINS HARBOR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 AUBURN ST APT 1
AUBURNDALE MA
02466-1826
US

IV. Provider business mailing address

465 AUBURN ST APT 1
AUBURNDALE MA
02466-1826
US

V. Phone/Fax

Practice location:
  • Phone: 617-340-9983
  • Fax:
Mailing address:
  • Phone: 617-340-9983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER HAWKINS
Title or Position: MANAGER
Credential: LMHC
Phone: 508-344-4451