Provider Demographics
NPI:1043781644
Name:EARLE, HALEN (LCPC, MS)
Entity Type:Individual
Prefix:
First Name:HALEN
Middle Name:
Last Name:EARLE
Suffix:
Gender:M
Credentials:LCPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2748
Mailing Address - Country:US
Mailing Address - Phone:802-922-4706
Mailing Address - Fax:
Practice Address - Street 1:116 W PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2748
Practice Address - Country:US
Practice Address - Phone:802-922-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-09
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC5997101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health