Provider Demographics
NPI:1114396157
Name:HALE, SHAYLEE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHAYLEE
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 E US HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-9125
Mailing Address - Country:US
Mailing Address - Phone:405-422-8800
Mailing Address - Fax:
Practice Address - Street 1:S. WALBAUM RD
Practice Address - Street 2:
Practice Address - City:CALUMET
Practice Address - State:OK
Practice Address - Zip Code:73014
Practice Address - Country:US
Practice Address - Phone:405-648-2148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical