Provider Demographics
NPI:1497958847
Name:HALE, SANDRA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 WOODLAND HILLS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4630
Mailing Address - Country:US
Mailing Address - Phone:404-321-4954
Mailing Address - Fax:404-321-1928
Practice Address - Street 1:1900 CENTURY PL NE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-4307
Practice Address - Country:US
Practice Address - Phone:404-321-4954
Practice Address - Fax:404-321-1928
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional