Individual
MS. VANESSA MARIA HAWKINS STATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LPA
Contact information
Practice address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-4195
(704) 364-1106
(866) 210-4848
Mailing address
6809 FAIRVIEW RD, CHARLOTTE, NC 28210-4195
(704) 364-1106
(866) 210-4848
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1079
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135WW
BCBS
NC
01
—
4364854
NC
NC
Enumeration date
07/13/2006
Last updated
05/19/2025
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