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NPI Code Detail

MEDICARE: MS. STACEY S. HALLMARK-MORALES LMHC

MEDICARE:  MS. STACEY S. HALLMARK-MORALES  LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH 60632352WA

General Provider Information

NPI Number : 1144641622
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STACEY S. HALLMARK-MORALES LMHC
Provider Business Mailing Address
First Line : PO BOX 11313
Second Line :
City : OLYMPIA
State : WA
Zip : 98508-1313
Country : US
Telephone Number : 360-561-4796
Fax Number :
Provider Business Practice Location Address
First Line : 1219 11TH AVE NE SUITE 101
Second Line :
City : OLYMPIA
State : WA
Zip : 98501-1313
Country : US
Telephone Number : 360-561-4796
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2013
Last Update Date : 01/24/2019

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Directions to “ MS. STACEY S. HALLMARK-MORALES LMHC” Practice Location

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