Provider Demographics
NPI:1326407776
Name:HALE, JUSTINE G (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:G
Last Name:HALE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 OAK ST APT A411
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-7471
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 OAK ST APT A411
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-7471
Practice Address - Country:US
Practice Address - Phone:347-653-9547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-13
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
014266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY741965935-00OtherFIDELIS CARE