MEDICARE: MARCELLA ALICE HALE LPC-A

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
1	101YP2500X	Professional Counselor	10569	SC

General Provider Information

NPI Number	:	1851255806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCELLA ALICE HALE LPC-A

Provider Business Mailing Address
First Line	:	700 DANIEL ELLIS DR APT 14306
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-3088
Country	:	US
Telephone Number	:	843-256-3027
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 DANIEL ELLIS DR APT 14306
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29412-3088
Country	:	US
Telephone Number	:	843-864-4675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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