Healthcare Provider Details

I. General information

NPI: 1871764068
Provider Name (Legal Business Name): HALE AND ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2738 E. 00 N.S.
KOKOMO IN
46901-6631
US

IV. Provider business mailing address

2738 E. 00 N.S.
KOKOMO IN
46901-6631
US

V. Phone/Fax

Practice location:
  • Phone: 765-236-1964
  • Fax: 765-236-1960
Mailing address:
  • Phone: 765-236-1964
  • Fax: 765-236-1960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39000223A
License Number StateIN

VIII. Authorized Official

Name: MR. GREGORY A. HALE
Title or Position: OWNER
Credential: LMHC
Phone: 765-236-1964