Healthcare Provider Details

I. General information

NPI: 1649044322
Provider Name (Legal Business Name): JULIA HARPER HAWKINS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SHELDON AVE SE
GRAND RAPIDS MI
49503-4295
US

IV. Provider business mailing address

516 PROSPECT AVE SE
GRAND RAPIDS MI
49503-5340
US

V. Phone/Fax

Practice location:
  • Phone: 616-454-9922
  • Fax:
Mailing address:
  • Phone: 616-514-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801116632
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: