Provider Demographics
NPI:1033324041
Name:HALE, MICHAEL LOUIS (DMIN, LCSW,CFLE)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:HALE
Suffix:
Gender:M
Credentials:DMIN, LCSW,CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4948 LATTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-2495
Mailing Address - Country:US
Mailing Address - Phone:910-425-3790
Mailing Address - Fax:910-423-8494
Practice Address - Street 1:4948 LATTIMORE ST
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-2495
Practice Address - Country:US
Practice Address - Phone:910-425-3790
Practice Address - Fax:910-423-8494
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0021111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical