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NPI Code Detail

MEDICARE: DR. SUZAN LYNN HAWKES PHD, LSCSW

MEDICARE: DR. SUZAN LYNN HAWKES PHD, LSCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1303KS

General Provider Information

NPI Number : 1548258049
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZAN LYNN HAWKES PHD, LSCSW
Provider Business Mailing Address
First Line : 1408 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-4145
Country : US
Telephone Number : 785-776-4105
Fax Number : 785-537-2299
Provider Business Practice Location Address
First Line : 1408 POYNTZ AVE
Second Line :
City : MANHATTAN
State : KS
Zip : 66502-4145
Country : US
Telephone Number : 785-776-4105
Fax Number : 785-537-2299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2005
Last Update Date : 07/08/2007

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