Individual provider Active NPI

La'Trevia Condeeja Hawkins

  • Clinical Social Worker
  • Katy, TX
National Provider Identifier
1841903473
Registry record updated Jun 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
67557 Issued in TX
Practice address
602 W Grand Pkwy S
Katy, TX 77494-8328
Phone
(000) 000-0000
NPI assigned
Dec 28, 2022
Last updated
Jun 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 67557 TX Primary
Clinical Social Worker 1041C0700X 28799 MD
Clinical Social Worker 1041C0700X I.2405701 OH

Addresses

Primary practice location

602 W Grand Pkwy S
Katy, TX 77494-8328

Mailing address

602 W Grand Pkwy S
Katy, TX 77494-8328
Phone (000) 000-0000

Other practice location 1

955 N 21st St
Newark, OH 43055-2921
Phone (000) 000-0000

Other practice location 2

1220 Augusta Dr Ste 290
Houston, TX 77057-2263
Phone (713) 428-8700

Other identifiers 3

IdentifierTypeStateIssuer
0094MedicaidVA
2717MedicaidTX
3302MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250707000501 TX Practitioner - Clinical Social Worker 7012421704 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28799MDMDClinical Social Worker
I.2405701OHMDClinical Social Worker
67557TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tanglewood Behavioral Health Group PC Clinical CurrentSince May 30, 2025 Accepting new patients
Balanced Mental Health and Wellness CurrentSince Apr 13, 2025 Accepting new patients

Locations

1220 Augusta Dr
Ste 290
Houston, TX 77057
Phone (713) 428-8700

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781395200000",
    "number": "1841903473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W GRAND PKWY S",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948328",
            "telephone_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W GRAND PKWY S",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948328",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 N 21st St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430552921",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 Augusta Dr Ste 290",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770572263",
            "country_code": "US",
            "telephone_number": "713-428-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "LA'TREVIA",
        "middle_name": "CONDEEJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2026-06-14",
        "certification_date": "2026-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67557",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "28799",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405701",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2717",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3302",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.