Provider Demographics
NPI:1104340975
Name:HALE, RICHARD ALEXANDER (MHP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALEXANDER
Last Name:HALE
Suffix:
Gender:M
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2608
Mailing Address - Country:US
Mailing Address - Phone:240-439-0983
Mailing Address - Fax:
Practice Address - Street 1:106 N PECAN ST
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-2524
Practice Address - Country:US
Practice Address - Phone:501-232-2600
Practice Address - Fax:501-242-0820
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2010094101YP2500X
171M00000X
AR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR255397719Medicaid