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NPI Code Detail

MEDICARE: STEPHANIE LEE HALES LCSW

MEDICARE: STEPHANIE LEE HALES LCSW
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
11041C0700XClinical Social WorkerC019649NC
2390200000XStudent in an Organized Health Care Education/Training Program
3104100000XSocial WorkerS.2207658OH

General Provider Information

NPI Number : 1164151338
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LEE HALES LCSW
Provider Business Mailing Address
First Line : 4154 SAVANNAH GROVE LN
Second Line :
City : COLUMBUS
State : OH
Zip : 43221-5680
Country : US
Telephone Number : 216-870-8631
Fax Number :
Provider Business Practice Location Address
First Line : 6302 FAIRVIEW RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-2227
Country : US
Telephone Number : 704-584-9897
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2022
Last Update Date : 02/23/2026

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