Individual provider Active NPI

Sheila Hawkins, PH.D, LMSW

  • Social Worker
  • Jackson, MS
National Provider Identifier
1700664620
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M3917 Issued in MS
Practice address
2219 Greenway Dr
Jackson, MS 39204-3202
Phone
(601) 983-7494
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M3917 MS Primary

Addresses

Primary practice location

2219 Greenway Dr
Jackson, MS 39204-3202

Mailing address

110 Windy Hill CV
Raymond, MS 39154-9793
Phone (601) 278-9424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240715002100 MS Practitioner - Clinical Social Worker 1456896455 Reassigns benefits to 1 organization
I20250124001138 IL Practitioner - Clinical Social Worker 1456896455 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Clinic Wellness CurrentSince Jul 7, 2024 Accepting new patients
Fitness Clinic PastSince Sep 24, 2023 Accepting new patients

Locations

20303 Crawford Ave
Ste 230
Olympia Flds, IL 60461
Phone (708) 679-1000

2219 Greenway Dr
Jackson, MS 39204
Phone (601) 983-7494

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1700664620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WINDY HILL CV",
            "city": "RAYMOND",
            "state": "MS",
            "postal_code": "391549793",
            "telephone_number": "601-278-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 GREENWAY DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043202",
            "telephone_number": "601-983-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "SHEILA",
        "credential": "PH.D, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M3917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.