Provider Demographics
NPI:1033752019
Name:THOMAS HALE, LAUREN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:THOMAS HALE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SANTA MARIA ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-7082
Mailing Address - Country:US
Mailing Address - Phone:832-878-3104
Mailing Address - Fax:
Practice Address - Street 1:306 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5215
Practice Address - Country:US
Practice Address - Phone:832-878-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77747101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX77747OtherTEXAS BOARD OF EXAMINERS PROFESSIONAL COUNSELORS