Healthcare Provider Details

I. General information

NPI: 1417218553
Provider Name (Legal Business Name): TAMARA L. HALE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMARA REEDER LCPC

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1769 JAMESTOWN RD STE 207
WILLIAMSBURG VA
23185-2307
US

IV. Provider business mailing address

1769 JAMESTOWN RD STE 207
WILLIAMSBURG VA
23185-2307
US

V. Phone/Fax

Practice location:
  • Phone: 208-912-0292
  • Fax: 208-912-0299
Mailing address:
  • Phone: 208-912-0292
  • Fax: 208-912-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC-5858
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701007258
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: