Healthcare Provider Details

I. General information

NPI: 1497551261
Provider Name (Legal Business Name): HALLE A LESUEUR MS, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HALLE A MOSLEY

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MADISON AVE FL 2
NEW YORK NY
10010-1600
US

IV. Provider business mailing address

1200 GRANDE OAK BLVD APT 404
SARALAND AL
36571-3734
US

V. Phone/Fax

Practice location:
  • Phone: 855-629-0554
  • Fax:
Mailing address:
  • Phone: 601-940-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL674
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: