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NPI Code Detail

MEDICARE: KRISTIN PHILLIPS HALE MS, LMHC

MEDICARE: KRISTIN PHILLIPS HALE MS, LMHC
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
1101YS0200XSchool Counselor732418IN
2101YM0800XMental Health Counselor39002479AIN

General Provider Information

NPI Number : 1497707103
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN PHILLIPS HALE MS, LMHC
Provider Business Mailing Address
First Line : 1710 PEMBERTON LN
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1576
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5638 PROFESSIONAL CIR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-5042
Country : US
Telephone Number : 317-247-8900
Fax Number : 317-247-8935
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 06/07/2013

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