Individual provider Active NPI

Carol Lynn Hawker

  • Addiction (Substance Use Disorder) Counselor
  • Jackson, OH
National Provider Identifier
1912599036
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.174496 Issued in OH
Practice address
84 E Mound St
Jackson, OH 45640-1226
Phone
(740) 577-3834
Fax
(740) 577-3834
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.169066 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.174496 OH Primary

Addresses

Primary practice location

84 E Mound St
Jackson, OH 45640-1226

Mailing address

84 E Mound St
Jackson, OH 45640-1226
Phone (740) 577-3834

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

LicenseStateTypeSpecialty
CDCA.174496OHMDAddiction (Substance Use Disorder) Counselor
RN.169066OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Warriors 4 Christ Recovery Ministries Addiction (Substance Use Disorder) CurrentSince Feb 14, 2021 Accepting new patients
Warriors 4 Christ Recovery Ministries CurrentSince Feb 14, 2021 Accepting new patients

Locations

84 E Mound St
Jackson, OH 45640
Phone (740) 577-3834

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": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1912599036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 E MOUND ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401226",
            "telephone_number": "740-577-3834",
            "fax_number": "740-577-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 E MOUND ST",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401226",
            "telephone_number": "740-577-3834",
            "fax_number": "740-577-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKER",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.169066",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.174496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.