Healthcare Provider Details
I. General information
NPI: 1770988677
Provider Name (Legal Business Name): CRYSTAL HAWKINS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/04/2014
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
212 SPRING LAKE CT
EGG HARBOR TOWNSHIP NJ
08234-8715
US
IV. Provider business mailing address
212 SPRING LAKE CT
EGG HARBOR TOWNSHIP NJ
08234-8715
US
V. Phone/Fax
- Phone: 856-254-0122
- Fax: 856-369-8970
- Phone: 856-254-0122
- Fax: 856-369-8970
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 37PC00505400 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: