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General NPI Number Information
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NPI Number | 1730692716
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Entity Type | Individual
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Provider Name | ROBERT HAWKINS
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Gender | Male
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 125 HARTWELL AVE
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City | LEXINGTON
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State | MA
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Zip | 02421-3100
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Country | US
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Telephone | 339-368-2488
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Fax |
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Provider Business Mailing Address
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Address Line | 324 CLARK ST
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City | WORCESTER
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State | MA
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Zip | 01606-1214
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Country | US
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Telephone | 978-503-1867
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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