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General NPI Number Information
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NPI Number | 1932288156
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Entity Type | Individual
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Provider Name | MARCIA ANNE DANIE HALE LSCW
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 157 PARK ST SUITE 35
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City | BANGOR
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State | ME
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Zip | 04401
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Country | US
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Telephone | 207-942-5055
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Fax | 207-942-7013
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Provider Business Mailing Address
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Address Line | PO BOX 1237
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City | BANGOR
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State | ME
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Zip | 04402
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Country | US
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Telephone | 207-942-5055
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Fax | 207-942-7013
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LC1058
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License Number State | ME
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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 | LC7699
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LC7699
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License Number State | ME
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