Provider Demographics
NPI:1871057133
Name:HAWKINSON, VALERIE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HAWKINSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-2554
Mailing Address - Country:US
Mailing Address - Phone:763-614-7837
Mailing Address - Fax:
Practice Address - Street 1:1200 S POKEGAMA AVE STE 160
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4296
Practice Address - Country:US
Practice Address - Phone:218-999-0051
Practice Address - Fax:218-999-7020
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-30
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN226491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical