MEDICARE: DR. HEATHER M HALE PSY.D., LCPC, CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	21668	IL
2	101YM0800X	Mental Health Counselor		IL
3	106H00000X	Marriage & Family Therapist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4932337	OTHER	IL	BC BS IL. PROVIDER NUMBER

General Provider Information

NPI Number	:	1467503508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER M HALE PSY.D., LCPC, CADC

Provider Business Mailing Address
First Line	:	900 NORTH SHORE DRIVE
Second Line	:	SUITE NO. 174
City	:	LAKE BLUFF
State	:	IL
Zip	:	60044-2243
Country	:	US
Telephone Number	:	847-615-1698
Fax Number	:	847-615-1697

Provider Business Practice Location Address
First Line	:	900 NORTH SHORE DRIVE
Second Line	:	SUITE NO. 174
City	:	LAKE BLUFF
State	:	IL
Zip	:	60044-2243
Country	:	US
Telephone Number	:	847-615-1698
Fax Number	:	847-615-1697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	09/11/2025

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Directions to “ DR. HEATHER M HALE PSY.D., LCPC, CADC” Practice Location

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