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General NPI Number Information
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NPI Number | 1275347155
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Entity Type | Individual
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Provider Name | ZACHARY ALLEN HALE LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5512 W WALSH LN STE 101
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City | ROGERS
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State | AR
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Zip | 72758-9015
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Country | US
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Telephone | 479-595-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 6 WILLOW CREEK LN APT 9201
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City | JONESBORO
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State | AR
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Zip | 72404-8695
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Country | US
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Telephone | 479-305-9026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L15884
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11459-C
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License Number State | AR
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