Healthcare Provider Details

I. General information

NPI: 1891324364
Provider Name (Legal Business Name): MRS. ADRIANNE HAWKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23290 FOUNTAIN DR
CLINTON TOWNSHIP MI
48036-1293
US

IV. Provider business mailing address

23290 FOUNTAIN DR
CLINTON TOWNSHIP MI
48036-1293
US

V. Phone/Fax

Practice location:
  • Phone: 586-843-7346
  • Fax:
Mailing address:
  • Phone: 586-843-7346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401223982
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: