MEDICARE: MR. JAMES O HALE MS, LPC, LADC-MH

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	56	OK
2	101YP2500X	Professional Counselor	2262	OK

General Provider Information

NPI Number	:	1922075159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES O HALE MS, LPC, LADC-MH

Provider Business Mailing Address
First Line	:	PO BOX 57366
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73157-7366
Country	:	US
Telephone Number	:	405-816-7735
Fax Number	:	405-286-1380

Provider Business Practice Location Address
First Line	:	3035 NW 63RD ST
Second Line	:	SUITE 200
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3632
Country	:	US
Telephone Number	:	405-816-7735
Fax Number	:	405-286-1380

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	03/14/2016

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