Active NPI
Garett Hawkinson
- Clinical Psychologist
- Concord, NC
National Provider Identifier
1265260558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6596
- Practice address
- 900 Branchview Dr NE Ste 215
Concord, NC 28025-2239 - Phone
- (704) 780-4271
- NPI assigned
- Jul 26, 2024
- Last updated
- Jul 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6596 | NC | Primary |
Addresses
Primary practice location
900 Branchview Dr NE Ste 215
Concord, NC 28025-2239
Mailing address
16255 Ventura Blvd Ste 830
Encino, CA 91436-2317
Phone (704) 780-4271
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6596 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1265260558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16255 VENTURA BLVD STE 830",
"city": "ENCINO",
"state": "CA",
"postal_code": "914362317",
"telephone_number": "704-780-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 BRANCHVIEW DR NE STE 215",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252239",
"telephone_number": "704-780-4271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWKINSON",
"first_name": "GARETT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-26",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "6596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.