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General NPI Number Information
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NPI Number | 1295526721
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Entity Type | Individual
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Provider Name | TICOLRYA ANNYHA LOVE HAWKINS LPC-A
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1109 BELLEVIEW ST STE 101
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City | COLUMBIA
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State | SC
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Zip | 29201-1872
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Country | US
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Telephone | 803-846-2499
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Fax |
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Provider Business Mailing Address
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Address Line | 1298 RABON POND DR
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City | COLUMBIA
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State | SC
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Zip | 29223-5869
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Country | US
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Telephone | 803-200-4185
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10370
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License Number State | SC
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