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General NPI Number Information
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NPI Number | 1255773446
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Entity Type | Individual
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Provider Name | LINA HAWTHORNE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 1050 CROWN POINTE PKWY
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City | ATLANTA
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State | GA
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Zip | 30338-7707
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Country | US
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Telephone | 478-227-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 604 GA HIGHWAY 247 S UNIT 762
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City | BONAIRE
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State | GA
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Zip | 31005-7231
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Country | US
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Telephone | 478-227-7535
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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 | SW11398
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005006
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License Number State | GA
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