Healthcare Provider Details

I. General information

NPI: 1639814478
Provider Name (Legal Business Name): EVELYN E HALE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55B STAFFORDSHIRE LN
CONCORD MA
01742-3218
US

IV. Provider business mailing address

55B STAFFORDSHIRE LN
CONCORD MA
01742-3218
US

V. Phone/Fax

Practice location:
  • Phone: 617-462-1844
  • Fax:
Mailing address:
  • Phone: 617-462-1844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EVELYN EVERETT HALE
Title or Position: PSYCHIATRIST
Credential: M.D.
Phone: 617-462-1844