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General NPI Number Information
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NPI Number | 1184211039
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Entity Type | Individual
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Provider Name | ELIZABETH HEALY HAWKINS LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/27/2020
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Last Update Date | 12/27/2020
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Provider Practice Location Address
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Address Line | 519 SUGARPINE DR
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451-8412
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Country | US
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Telephone | 512-299-7116
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Fax |
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Provider Business Mailing Address
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Address Line | 930 TAHOE BLVD STE 802 PMB 673
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451-9488
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Country | US
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Telephone | 512-299-7116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 85916
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License Number State | CA
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