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General NPI Number Information
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NPI Number | 1205344843
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Entity Type | Organization
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Legal Business Name | KELSEY HALE LPC LLC
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 59 DEMING RD
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City | BERLIN
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State | CT
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Zip | 06037-1512
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Country | US
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Telephone | 860-916-2228
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Fax |
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Provider Business Mailing Address
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Address Line | 59 DEMING RD
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City | BERLIN
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State | CT
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Zip | 06037-1512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MS. KELSEY HALE
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Credential | LPC
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Telephone | 860-398-5584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3357
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License Number State | CT
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