Provider Demographics
NPI:1497496871
Name:HALE, SHAWNA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:KALBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4916 E DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6434
Mailing Address - Country:US
Mailing Address - Phone:480-645-3177
Mailing Address - Fax:
Practice Address - Street 1:1930 S ALMA SCHOOL RD STE C105
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3067
Practice Address - Country:US
Practice Address - Phone:480-645-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20898101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health