Healthcare Provider Details

I. General information

NPI: 1366679755
Provider Name (Legal Business Name): CAROL A. HAWKER L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 ARMSTRONG ST
FAIRFAX VA
22030-3648
US

IV. Provider business mailing address

9662 SPRINGS RD
WARRENTON VA
20186-7854
US

V. Phone/Fax

Practice location:
  • Phone: 703-385-7575
  • Fax: 703-385-7578
Mailing address:
  • Phone: 540-341-7880
  • Fax: 703-385-7578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701002959
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: